March 20, 2018 Dear James, Thank you for taking the time to contact me about Medicare coverage for dialysis. Like you, I believe that Medicare should provide high quality care to its beneficiaries, and I am committed to working with my colleagues on both sides of the aisle to strengthen the Medicare program for the future. Individuals who develop end-stage renal disease (ESRD) require either a regular course of dialysis treatment or a kidney transplant to survive. Dialysis treatment helps perform some of the tasks of healthy kidneys and must be completed multiple times per week. Medicare provides coverage for health care services for the vast majority of individuals diagnosed with ESRD through Medicare Part A and Medicare Part B. As you may know, Medicare Administrative Contractors (MACs) are responsible for developing Local Coverage Determinations (LCDs) within their areas of jurisdiction. LCDs help determine if certain medical services are reasonable and necessary for Medicare coverage in a geographic area. Recently, several MACs proposed new LCDs that would change the rules for determining which Medicare patients are eligible to receive more than three dialysis treatments in a week. As your Senator, I will continue to closely monitor this situation. Should legislation addressing this issue come before the Senate for a vote, I will be sure to keep your thoughts in mind. It is a privilege to represent you and all Hoosiers in the Senate. Your continued correspondence is welcome and helps me to better represent our state. I encourage you to write, call, or email if my office can ever be of assistance. You can also check out my Facebook page, follow me on Twitter, or visit my website. Please note when contacting my Senate office that I am only able to respond to questions or concerns related to official Senate business. As such, this letter addresses the issues you raised, which relate to my work in the United States Senate.