Why It Matters
Kidney Care Partners is pushing to fix a fundamental mismatch between Medicare’s outdated ESRD payment system and modern kidney care realities. The organization seeks legislative and regulatory changes ensuring patients can access new therapies and maintain private insurance coverage without administrative delays.
The strategy centers on two complementary bills: the Kidney Care Access Protection Act of 2025 (S. 2730) to modernize Medicare reimbursement for innovative treatments, and the Restore Protections for Dialysis Patients Act (RESTORE Act) to strengthen protections against insurance discrimination. KCP is simultaneously engaging on proposed CMS rules for the 2026 ESRD payment system and Medicare Advantage requirements—a multi-pronged approach requiring pressure on both Congress and federal agencies.
By the Numbers
KCP has lobbied continuously since 2003, spending over $18 million across all firms. For fourth quarter 2025, the organization reported $75,000 to Lester Health Law PLLC, continuing a long-standing relationship. Kathleen J. Lester leads the engagement with over two decades of specialized ESRD expertise.
KCP maintains a multi-firm strategy: BGR Government Affairs LLC represents their largest spend at $4.22 million across 53 filings, while Lester Health Law accounts for $2.94 million across 49 filings since 2014. DaVita spent over $4.2 million on identical legislative priorities in 2025, suggesting coordinated industry strategy.
The Agenda
Kidney Care Partners is lobbying on interconnected kidney care priorities. Beyond supporting the bipartisan RESTORE Act and Kidney Care Access Protection Act, KCP engages on proposed ESRD Prospective Payment System rules for 2026 and Medicare Advantage rate-setting changes.
Major providers DaVita Inc. and Fresenius Medical Care are simultaneously lobbying on identical priorities, indicating coordinated industry advocacy.
Broader Context
Congress is advancing kidney care legislation while regulators address systemic access problems. Both the Kidney Care Access Protection Act and RESTORE Act enjoy bipartisan support from members like Rep. Carol Miller and Sens. Cassidy and Booker.
Meanwhile, CMS ended its ESRD Treatment Choices payment experiment early after failing to shift patients toward home dialysis. Recent research shows MA patients face lower transplant waitlist odds, while Senator Blumenthal pushes FTC investigation into potential anti-competitive conduct in a market where DaVita and Fresenius control 75 percent of dialysis clinics.
Between The Lines
A House Ways and Means hearing on Medicare Advantage in July examined prior authorization burdens affecting ESRD patients. Senators Cassidy, Booker, Cramer, and Heinrich are promoting the RESTORE Act while Reps. Miller and Sewell champion the Kidney Care Access Protection Act.
CMS is simultaneously shaping ESRD policy through annual payment rules and new Medicare Advantage regulations establishing stricter prior authorization timelines—creating regulatory momentum alongside legislative efforts.
Competitive Landscape
KCP isn’t alone. DaVita spent over $4.2 million in 2025 targeting identical bills, while Fresenius Medical Care lobbies on removing ESRD payment innovation barriers. Ardelyx Inc., a kidney pharmaceutical company, also engages on ESRD reimbursement.
This reveals industry consensus on legislative priorities, though interests diverge on market concentration issues facing federal scrutiny.
The Bottom Line
KCP maintains steady pressure during significant regulatory activity. Its fourth quarter 2025 lobbying reflects broader industry consensus—major providers advocate for the same bills amid federal scrutiny of market consolidation and documented Medicare Advantage access disparities. The failed CMS payment experiment shifts focus toward legislative solutions for innovation barriers in kidney care.
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