WASHINGTON, October 4, 2022 – The ERISA Industry Committee (ERIC) has joined a broad coalition of stakeholders representing employers, labor groups, and State and Local governmental health plans strongly opposing legislation drafted by the dialysis industry to increase profits out of the pockets of employers and workers, the Restore Protections for Dialysis Patients Act (RPDPA) (H.R. 8594 and S. 4750).
Stakeholders find that the legislation would eliminate the ability of employer-sponsored group health plans to build their health care networks, would increase costs for kidney dialysis treatment, and would make it impossible for plan sponsors to manage appropriate levels of coverage for dialysis patients, as well as for employees with other chronic conditions.
The RPDPA attempts to overturn the Supreme Court decision in Marietta Memorial Hospital Employee Health Benefit Plan Et Al. V. Davita Inc. Et Al. , which reaffirmed current law, in which group health plans can utilize cost-control designs under the Medicare Secondary Payment Act (MSPA), so long as plans offer the same terms of coverage for outpatient dialysis services for all participants. Instead, under the proposed legislation, employers would be required to essentially pay any amount demanded by the highly consolidated dialysis industry (in which two companies control more than 80 percent of the market), or make draconian cuts to health benefits for patients with chronic conditions.
“This legislation would increase profits to the dialysis industry, but would make health benefits worse for patients, while increasing their costs,” said James Gelfand, President of ERIC. “We are now working with some of our allies and coalitions to better inform and educate legislators about the negative effects of this bill, and help them understand the needs of American workers who require dialysis on an ongoing basis.”