FROM: Chris Blagg, MD, and Robert Lockridge Jr., MD

As the House of Representatives in Washington, DC develops the new Medicare Bill, the draft includes a provision that increases payment for dialysis in a center BUT WOULD PAY FOR THIS BY SIGNIFICANTLY REDUCING PAYMENT FOR HOME DIALYSIS. This would be disastrous for both home hemodialysis and peritoneal dialysis. The wording of this ESRD provision is as follows: "Increased composite rate for facility-based dialysis treatment funded out of the corresponding reduction in composite rate for home-based dialysis treatment." The results of this ESRD provision (based on 90% of dialysis patients in US on in-center dialysis and 10% of dialysis patients in US on peritoneal and home hemodialysis) would be a 2.6% increase composite rate in the facility-based dialysis treatment which would result in corresponding 20 to 25% reduction of the composite rate for home-based dialysis treatment.

Inadequate payment would harm patients on both home peritoneal dialysis (CAPD and CCPD) and home hemodialysis, as it would be a major financial disincentive for dialysis units to continue these programs and an even greater barrier to the development of new home dialysis programs.

As soon as possible, because this bill will be marked up next week (5-8-02), please call the office of Congresswoman Nancy Johnson, Chair of the House Ways and Means Subcommittee on Health at 202-225- 4476 and/or fax her at 202-225-4488 and call the office of Congressman Michael Bilirakis, Chair of the House Energy and Commerce Committee Health Subcommittee at 202-225-5755 and/or fax him at 202-225-4085. Inform them that you are opposed to this ESRD provision. Do not mail letters - they are slow in getting there because of precautions with mail. Also, attached are the names and addresses of the members of the Health Subcommittees of the Ways and Means and the Energy and Commerce Committees. They will be considering this legislation over the next few weeks. If any of your state's Representatives are listed (other than Washington State), you should contact them too.

House Ways and Means Health Subcommittee contact list
Energy and Commerce Health Subcommittee contact list

Use your own words to: WHO ELSE IS CONCERNED:
In addition to individual physicians, patients and dialysis programs, various organizations including the American Association of Kidney Patients, the American Nephrology Nurses Association, the National Kidney Foundation and the Renal Physicians are also concerned about this provision, as are several of the manufacturers of dialysis equipment and others. PERSONALISE YOUR COMMENTS: If you are a patient who has been treated by home hemodialysis or peritoneal dialysis, say how this has benefited you. If you are an in-center dialysis patient, comment on whether you were given the opportunity to select home hemodialysis and CAPD or CCPD and point out that destroying these treatments will eliminate patient choice. If you are a member of the renal community, comment from your experiences. If you have questions please feel free to email Dr. Christopher R. Blagg at or Dr. Robert S Lockridge at

Chris Blagg, M.D.
Robert S. Lockridge, Jr., M.D.

Contact info for Dr. Lockridge:
Phone:434-947-3954 Ext 111
103 Clifton Street
Lynchburg, Virginia 24501