“Providers and patient groups in this area have been consistent in pushing for a fix in light of the ruling,” a Republican Senate aide granted anonymity to speak about the advocacy told POLITICO. The lobbying began around December when the Biden administration filed a brief in support of the group health plan, the aide said, but “ramped up a ton” after the June 21 decision.
DaVita has flexed its political muscles to close what it calls a “loophole” created by the opinion — which said that current law, while prohibiting plans from offering different benefits to beneficiaries with end-stage renal disease, is not explicit about requiring plans to cover dialysis services.
Three weeks after DaVita’s Supreme Court loss, Kathleen Waters, the company’s chief legal officer, and Kelly Philson, one of its top lobbyists, drafted proposed legislative language that would make additions to the Medicare statute at issue in the case, according to the metadata within a Word document obtained by POLITICO. The proposal would create coverage parity for dialysis services “as compared to other covered medical services” provided by the plan. There is no outward indication the text is from DaVita.
While pushing for changes, advocates sought to assure lawmakers that they weren’t trying to expand coverage, according to a summary document also obtained by POLITICO. While the broad phrasing could be “gamed by a plan” to create a “‘skinny’ plan that does not cover benefits for any chronic conditions,” the summary reads, it “highlights our intent not to create a mandate.”
On July 29, a bipartisan group of 17 House members introduced a bill that largely mirrored the proposal, and Sens. Bob Menendez (D-N.J.) and Bill Cassidy (R-La.) followed with a Senate companion on Aug. 3. Instead of creating parity between dialysis treatments and other services generally, it would prohibit a group health plan from putting “limits, restrictions, or conditions” on dialysis benefits compared to services needed to treat other chronic conditions the plan covers.
“After the Supreme Court decision in June created a loophole, members of Congress who are concerned about the potential harmful impact to their constituents in this vulnerable patient population started working to restore the protections under the Medicare Secondary Payer Act,” a DaVita spokesperson said in an emailed statement in response to an inquiry from POLITICO about the company’s involvement in the proposal and its lobbying and campaign activity.
In addition to spending roughly $4 million a year on its lobbying efforts, DaVita has a prolific political action committee.
Each of the 17 co-sponsors of the House bill has received campaign money from DaVita’s PAC since January 2021, totaling $67,000, according to OpenSecrets, which tracks political spending. Five co-sponsors also received contributions to their leadership PACs, Federal Election Commission records show.
Industries often contribute to lawmakers who work on their issues, so it’s not unusual that DaVita has given thousands of dollars to most of those members — almost all of whom sit on committees with…