House Ways and Means hearing presses Medicare payment changes to spur kidney‑care innovation; patient urges wider access to home dialysis

At a House Ways and Means subcommittee hearing, members and witnesses urged federal action to modernize Medicare payment rules, increase kidney research funding, and expand access to home dialysis and transplantation.

"Dialysis is the reason I am alive," Ashley Littleton, an end‑stage renal disease patient from Clarksville, Tennessee, told the panel as she described starting dialysis at 27, the burdens of in‑center treatment, and the life changes made possible by switching to home hemodialysis. Littleton said home care allowed her to return to work and regain control, but she warned that many patients arrive at dialysis without clear information about options and called for repeated, patient‑centered education.

Clinicians and industry witnesses told the committee that payment design is a major barrier to innovation. "TDAPA lasts for two years," John Butler, president and CEO of Akebia Therapeutics, said of CMS's transitional drug add‑on payment adjustment, adding that the program's temporary…