• 2020 NRAA Call for Presentations

    NRAA seeks presenters who can offer:
    Case studies of "lessons learned" in quality improvement
    First-hand experience implementing new programs, procedures or technologies
    Insightful techniques to maximize quality outcomes and reduce costs
    Practical ways to communicate and engage with patients and staff
    Practical ways to enhance the functioning of the interdisciplinary team
    Effective programs for promoting patient safety and reducing risks
  • NRAA Statement in Response to Executive Order on Advancing American Kidney Health

    NRAA Responds to Executive Order on Advancing American Kidney Health:: “Independent dialysis providers strongly support innovation, expanded treatment options, disease education and improved preventive care for patients with advanced kidney disease...." states Julie Williams, Administrator at Branson Dialysis and NRAA President.

    Self-nominate by: Sunday, August 4

    Every summer the NRAA Nominating Committee accepts self-nominations from potential dynamic leaders interested in leading NRAA into the future. As the Primary Representative of your Active Member Company, you are likely qualified to run for a position on the Board*. All members are encouraged to give serious consideration to this opportunity. This is a time consuming commitment, but the satisfaction of being in the position to influence potential changes to your industry will make it all worthwhile.
  • Call for NRAA Hospital-Based Acute Dialysis Partners

    The NRAA is seeking 6-8 volunteers who will be able to meet regularly to participate in a task force whose goal is to discuss the unique aspects that need to be managed in an Acute dialysis setting. From these discussions the task force will develop webinar programs or other educational material that will launch in 2020.

    Background: The NRAA Quality Committee identified a need to provide education and resources and build upon the network for management of Acute Dialysis programs. What is different in an acute program? How do you create staffing patterns? Who do you hire and how do you retain them? They are unique, isolated and SO independent in/the function of performing their roles. What strategy is implemented to combat this? What’s different about the built environment in acute care? What special populations are served? How can you track and report quality measures such as AKI recovery? If apheresis is a portion of your work-flow, how do you build success? Other key elements include urgent/emergent coverage for PD/home. What tools does the leader of the program have? The front-line staff? How important is autonomy in the nurse who works in an acute program?


    Project Goal/Description: Develop educational webinars and share quality tools that would prepare professionals to handle difficult discussions with their patients on transitional care and improve outcomes. Learning objectives to be centered around first identifying what is different about management in an Acute/inpatient setting versus the ESRD facility. Other partnerships could include “transitional” care out of the facility, palliative (ethics)/ACP, CMS Survey Reorientation/JCAHO, what should be audited for acute programs/ role of the Medical Director Leader, Home Referrals: Education.

    Length of Commitment: July 2019 – December 2019

    Frequency of Teleconference Calls: Up to weekly for one full hour to a minimum of meeting twice a month as needed to complete activities.

    Anticipated Timeline of Activities:

    1.      Define the scope of the problem – develop team objectives

    2.      Identify staffing patterns/define the standard.

    3.      Determine controllable variables in Acute Program – Quality Metrics

    4.      Review workforce planning

    5.      Define the “other” work done by acute teams (peritonitis, apheresis, etc)

    6.      Built environment

    Apply: Interested individuals should submit their interest to  In a few short sentences tell us how your experience can shape the future of Acute Dialysis across the country. This information will be submitted and a work-plan for 2020 will be determined. Space is limited*. 

    *NRAA is seeking 6-8 individuals
  • Membership Dues Renewal

    Required to receive member discount to the 2019 Annual Conference (registration opening soon). 

    Due: June 30, 2019

    Each company membership includes one primary contact. The primary contact:

    • Receives NRAA mailings and has access to the members only section of the NRAA website
    • Receives member discounted rates on registration fees
    • Is eligible to serve on NRAA committees
    • Votes on behalf of their company in annual Board elections
    • Can run for a position on the NRAA Board of Directors (nominations open in June)

    Each company can add unlimited individuals (Additional Contacts) at $50/each. Additional contacts:

    • Receive NRAA mailings and have access to the members only section of the NRAA website
    • Receive member discounted rates on registration fees
    • Are eligible to serve on NRAA committees
    NOTE: Company dues must be paid in order for:

    • Primary Representatives to be eligible to participate in the Board elections
    • Primary Representatives to be eligible to vote
    • Receive member discounted registration rates for the upcoming NRAA Annual Conference.  NOTE: Only Primary Contacts andAdditional Contacts are eligible to receive the discounted member registration.

    Please follow these online payment instructions to complete the renewal of your organization’s NRAA membership.   

    Step 1 – Sign In

    • Enter your Username and Password

    Step 2 – Begin Dues Renewal

    • Click ‘Renew Dues’ to proceed in the menu options of the toolbar
    Step 3 – Review Your Member Roster (Primary's Only)

    • View your organization’s ‘Member Roster’ to review the Additional Contacts of your organization. This will include yourself as the Primary Contact and may contain others who are Additional Contacts of your organization’s NRAA membership.
    Click on each individual’s name and choose one of the following options:

    • ‘Remove from Roster’ (selecting this option will resign the individual’s NRAA membership);
    • ‘Pay Own Dues’ (selecting this option allows the individual to access the ‘Pay My Dues’ option upon logging into Members Only, they will receive a separate email regarding the renewal of their individual membership upon completion of your organization’s renewal); OR When you have completed reviewing your ‘Member Roster’, click on ‘Return to Your Account’, located in the upper left corner and then click ‘Add Selected Items to Cart’ to proceed.

    Step 4

    • The total amount due will appear under ‘Cart Charges’
    • Enter your credit card information and click ‘Submit Order’.

    Step 6

    • You will be directed to an order confirmation page
    • Print this page for your records
    • A receipt will automatically be sent to the email on file
    • Your transaction is complete!

    Note for Invoice

    • If you would like to request an invoice, please contact NRAA headquarters at or call (215) 320-4984.

    Thank you for helping NRAA fuel your success! Please contact NRAA headquarters at or call (215) 320-4984 with any questions on the dues and/or login processes.
  • CMS finalizes policies to bring innovative telehealth benefit to Medicare Advantage

    April 5, 2019

    Contact: CMS Media Relations
    (202) 690-6145 | CMS Media Inquiries


    CMS finalizes policies to bring innovative telehealth benefit to Medicare Advantage
    Final Rule will strengthen popular Medicare private health insurance plans, expand telehealth access for patients, and improve coordination for dual-eligible individuals

    Today, the Centers for Medicare & Medicaid Services (CMS) finalized policies that will increase plan choices and benefits, including allowing Medicare Advantage plans to include additional telehealth benefits. These policies continue the agency’s efforts to modernize the Medicare Advantage and Part D programs, unleash innovation and drive competition to improve quality among private Medicare health and drug plans.

    “Today’s policies represent a historic step in bringing innovative technology to Medicare beneficiaries,” said CMS Administrator Seema Verma. “With these new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology and have greater access to telehealth. By providing greater flexibility to Medicare Advantage plans, beneficiaries can receive more benefits, at lower costs and better quality.”

    The final policies announced today leverage new authorities provided to CMS in the Bipartisan Budget Act of 2018, which President Trump signed into law last year. CMS is finalizing changes that would allow Medicare Advantage beneficiaries to access additional telehealth benefits, starting in plan year 2020. These additional telehealth benefits offer patients the option to receive health care services from places like their homes, rather than requiring them to go to a healthcare facility.

    Before this year, seniors in Original Medicare could only receive certain telehealth services if they live in rural areas. Starting this year, Original Medicare began paying for virtual check-ins across the country, meaning patients can connect with their doctors by phone or video chat. Historically, Medicare Advantage plans have been able to offer more telehealth services, compared to Original Medicare, as part of their supplemental benefits. But with the final rule, it will be more likely that plans will offer the additional telehealth benefits outside of supplemental benefits, expanding patients’ access to telehealth services from more providers and in more parts of the country than before, whether they live in rural or urban areas.

    CMS is also finalizing changes that will make improvements to Medicare Advantage and Part D Star Ratings so that consumers can identify high-value plans. The final rule updates the methodology for calculating Star Ratings, which provide information to consumers on plan quality. The new Star Ratings methodology will improve the stability and predictability for plans, and will adjust how the ratings are set in the event of extreme and uncontrollable events such as hurricanes.

    The final rule will improve the quality of care for beneficiaries dually eligible for Medicare and Medicaid who participate in “Dual Eligible Special Needs Plans” or D-SNPs. These beneficiaries usually have complex health needs and if they have a complaint about their healthcare or about access to items and services, they have to work with multiple organizations, one responsible for Medicare benefits and another responsible for Medicaid benefits, in order to file an appeal. The final rule will create one appeals process across Medicare and Medicaid, which will make it easier for enrollees in certain D-SNPs to navigate the healthcare system and have access to high quality services. The final rule will also require plans to more seamlessly integrate Medicare and Medicaid benefits across the two programs, such as notifying the state Medicaid agency (or its designee) of hospital and skilled nursing facility admissions for certain high-risk beneficiaries, to promote coordination of care for these patients.

    Today’s announcement builds on the 2020 Rate Announcement and Final Call Letter released earlier this week that gives Medicare Advantage plans flexibility to offer chronically ill patients a broader range of supplemental benefits that are not necessarily health related and can address social determinants of health. With these new telehealth and supplemental benefits, Medicare Advantage plans will have the flexibility to provide a historic set of offerings to beneficiaries. Medicare Advantage plans will be able to compete for patients based on their new offerings and overall cost. CMS is working to update the Medicare Plan Finder with these new choices, so that beneficiaries will be able to see their new choices and benefits and can pick the plans that work best for them.

    For a fact sheet on the CY 2020 Medicare Advantage and Part D Flexibility Final Rule (CMS-4185-F), please visit:

    The final rule can be downloaded from the Federal Register at:
  • NRAA Statement in Response to HHS Secretary Azar Kidney Care Remarks

    On March 4, 2019, HHS Secretary Alex Azar delivered remarks at the Kidney Patient Summit in Washington, D.C. The National Renal Administrators Association provides the following response:

    “As dialysis professionals, who are the front lines of witnessing the impact of chronic kidney disease on our patients, we were inspired to hear Secretary Alex Azar’s comments on the work and focus of his office and this administration.   We agree with him that the focus must shift to Kidney Health instead of Kidney Disease.  The dialysis community often gets the patients too late. With early detection, prevention, and progression strategies positive outcomes can occur with regularity.”

    “We agree that more work is needed to support home therapy options and technologies– specifically changes to reimbursement models.  Expanded early intervention and disease education efforts, we agree, are a piece of the puzzle.   On behalf of our patients, we applaud the efforts being made to improve organ utilization and would suggest that the Transplant Programs must be included as a part of the CKD process.  As an organization representing over 270 independent dialysis facilities across the U.S., we look forward to providing a voice for the independent community and working with Secretary Azar to reduce regulatory burdens and improve care for all kidney disease patients.”

    Julie Williams, President of the National Renal Administrators Association, is an administrator at Branson Dialysis with over 35 years in the kidney care industry.

  • HHS Proposes New Rules to Improve the Interoperability of Health Information

    February 11, 2019

    Contact: HHS Press Office

    HHS Proposes New Rules to Improve the Interoperability of Health Information

    New innovations in technology promote patient access and could make no-cost health data exchange a reality for millions

    The U.S. Department of Health and Human Services (HHS) today proposed new rules to support seamless and secure access, exchange, and use of electronic health information. The rules, issued by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), would increase choice and competition while fostering innovation that promotes patient access to and control over their health information. The proposed ONC rule would require that patient electronic access to this electronic health information (EHI) be made available at no cost.

    “These proposed rules strive to bring the nation’s healthcare system one step closer to a point where patients and clinicians have the access they need to all of a patient’s health information, helping them in making better choices about care and treatment,” said HHS Secretary Alex Azar. “By outlining specific requirements about electronic health information, we will be able to help patients, their caregivers, and providers securely access and share health information. These steps forward for health IT are essential to building a healthcare system that pays for value rather than procedures, especially through empowering patients as consumers.”

    CMS’ proposed changes to the healthcare delivery system support the MyHealthEData initiative and would increase the seamless flow of health information, reduce burden on patients and providers, and foster innovation by unleashing data for researchers and innovators. In 2018, CMS finalized regulations that use potential payment reductions for hospitals and clinicians to encourage providers to improve patient access to their electronic health information. For the first time, CMS is now proposing requirements that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges must provide enrollees with immediate electronic access to medical claims and other health information electronically by 2020.

    In support of patient-centered healthcare, CMS would also require these health care providers and plans to implement open data sharing technologies to support transitions of care as patients move between these plan types. By ensuring patients have easy access to their information, and that information follows them on their healthcare journey, we can reduce burden, and eliminate redundant procedures and testing thus giving clinicians the time to focus on improving care coordination and, ultimately, health outcomes.

    “Today’s announcement builds on CMS’ efforts to create a more interoperable healthcare system, which improves patient access, seamless data exchange, and enhanced care coordination,” said CMS Administrator Seema Verma.  “By requiring health insurers to share their information in an accessible, format by 2020, 125 million patients will have access to their health claims information electronically. This unprecedented step toward a healthcare future where patients are able to obtain and share their health data, securely and privately, with just a few clicks, is just the beginning of a digital data revolution that truly empowers American patients.”

    The CMS rule also proposes to publicly report providers or hospitals that participate in “information blocking,” practices that unreasonably limit the availability, disclosure, and use of electronic health information undermine efforts to improve interoperability.  Making this information publicly available may incentivize providers and clinicians to refrain from such practices.

    ONC’s proposed rule promotes secure and more immediate access to health information for patients and their healthcare providers and new tools allowing for more choice in care and treatment. Specifically, the proposed rule calls on the healthcare industry to adopt standardized application programming interfaces (APIs), which will help allow individuals to securely and easily access structured and unstructured EHI formats using smartphones and other mobile devices. It also implements the information blocking provisions of the 21st Century Cures Act, including identifying reasonable and necessary activities that do not constitute information blocking. The proposed rule helps ensure that patients can electronically access their electronic health information at no cost. The proposed rule also asks for comments on pricing information that could be included as part of their EHI and would help the public see the prices they are paying for their healthcare.

    “By supporting secure access of electronic health information and strongly discouraging information blocking, the proposed rule supports the bi-partisan 21st Century Cures Act. The rule would support patients accessing and sharing their electronic health information, while giving them the tools to shop for and coordinate their own health care,” said Don Rucker, M.D., National Coordinator for Health IT. “We encourage everyone – patients, patient advocates, healthcare providers, health IT developers, health information networks, application innovators, and anyone else interested in the interoperability and transparency of health information – to share their comments on the proposed rule we posted today.”

    Policies in the proposed CMS and ONC rules align to advance interoperability in several important ways. CMS proposes that entities must conform to the same advanced API standards as those proposed for certified health IT in the ONC proposed rule, as well as including an aligned set of content and vocabulary standards for clinical data classes through the United States Core Data for Interoperability standard (USCDI). Together, these proposed rules address both technical and healthcare industry factors that create barriers to the interoperability of health information and limit a patient’s ability to access essential health information. Aligning these requirements for payers, health care providers, and health IT developers will help to drive an interoperable health IT infrastructure across systems, ensuring providers and patients have access to health data when and where it is needed. 

    For a fact sheet on the CMS proposed rule (CMS-9115-P), please visit:

    For fact sheets on the ONC proposed rule, please visit:

    To receive more information about CMS’s interoperability efforts, sign-up for listserv notifications, here:

    To view the CMS proposed rule (CMS-9115-P), please visit:

  • Policies and Procedures for Peritoneal Dialysis (PD)

    Back last summer the Home Committee created two taskforces to work on the creation of policies and procedures for PD and HHD. These taskforces have been meeting regularly and the PD has available for you their catheter, immunization, and medication sections! If you're interested in participating in either one of these taskforces, please email Lauren Small at