ASN News

Program and Abstracts Info

The Program and Abstracts content will be available in two ways. First, the ASN web site hosts an online, searchable program that includes all the invited sessions and abstracts. You can search by topic and mark the sessions/posters you are interested in attending. Those sessions marked can then become a customized itinerary that can be printed or downloaded to a PDA. An electronic version of all abstracts will also be posted in a PDF file on the ASN website, so attendees also have the option of printing the PDF version prior to arriving in San Diego.

Don’t forget that to offer you a 5-week extension for submission of abstracts from previous years, the abstract supplement to JASN (the P&A Book) will be distributed onsite at Renal Week. All members who cannot attend Renal Week will receive their copy by mail after the conclusion of the meeting, in late November.

Don’t Forget to Attend

All ASN members are encouraged to attend ASN’s Annual Business Meeting on Monday, November 17, from 8:00 to 8:30 am. The business meeting will provide an overview of the Society’s activities for the past year as well as the current financial status of the Society. The presentation of the Belding H. Scribner Award, presented to Jack Coburn, MD, and Jacob Lemann, MD, and the State-of-the-Art Lecture, given by Mark Pepys, MD, will directly follow the meeting.

The recently added Clinical Trials Symposium, taking place on Monday from 10 am to noon and moderated by Josie Briggs and Paul Kimmel, will discuss the results of the following four clinical trials:

• Results of the Nonsteroidal Anti-Inflammatory Clinical Trial—William Henrich

• Results from the Southwest Pediatric Nephrology Study Group in IgA Nephropathy and Steroid-Dependent Nephrotic Syndrome—Ronald Hogg

• Dopamine Receptor 1 Agonists in Early Acute Tubular Necrosis: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial of Fenoldopam Mesylate—James Tumlin

• Lipid Lowering and Cardiovascular Outcomes in Type-Two Diabetics on Dialysis: The 4D Trial—Christoph Wanner

Finally, ASN’s new Official Dinner Symposia are fully developed by the ASN’s Postgraduate Education and Program Committees. These official programs will be the only dinner sessions presented during Renal Week. As with all parts of the meeting, educational grants for the symposia may be provided by various sponsors. Check the ASN web site at www.asn-online.org for current details, including program descriptions and times of all Official Evening Dinner Symposia!

Proposed NIH Restructuring

The National Research Council and the Institute of Medicine Committee on the Organizational Structure of the National Institutes of Health (NIH) released its public report in September. The congressionally mandated study examined whether or not organizational changes are needed at NIH to pursue more innovative and strategic research. The committee also sought to determine if the NIH Director required greater resources, authority, and flexibility in order to meet further challenges.

The report states that, despite the doubling of the NIH budget and numerous successes as the world’s largest supporter of biomedical research and training, important organizational changes are needed at the agency for it to meet future challenges. In particular, the committee recommended that changes are required to allow NIH to devote additional resources to innovative interdisciplinary research that reflects strategic objectives and cuts across all of the agency’s institutes and centers. They also encouraged Congress to establish a formal process to review and act on specific proposals for changes in the number of NIH institutes and centers, which currently total 27. This process should be used to study two mergers favored by the committee: combining the National Institute on Drug Abuse with the National Institute on Alcohol Abuse and Alcoholism, and combining the National Institute of General Medical Sciences with the National Human Genome Research Institute.

The committee’s other recommendations include the following: Congress should fund a new program for special projects to be run out of the NIH Director’s office; NIH-sponsored clinical research should be consolidated under a new entity, the National Center for Clinical Research and Research Resources; the special status of the National Cancer Institute should be reconsidered; Directors of NIH institutes and centers should be appointed to 5-year terms, with the option of a second and final term; and the authority to hire and fire NIH Directors should be switched from the HHS Secretary to the NIH Director.

Congressional representatives and leading research officials have expressed concerns that the NIH has become too fragmented and unwieldy. It was this primary concern that prompted Congress to request the National Research Council and Institutes of Medicine study. Another concern was whether the current organizational framework at NIH can accommodate the increasing pace of scientific advances. The committee noted, however, that it was not the first group of experts to look at this issue. In 1984, an Institutes of Medicine report also recommended that a formal process be established for the review of proposed organizational changes, though such a process was never put in place.

Copies of Enhancing the Vitality of the National Institutes of Health: Organizational Change to Meet New Challenges are available from the National Academy Press. http://www.nap.edu.

The Latest from CMS on End-Stage Renal Disease

The Centers for Medicare and Medicaid Services (CMS) is close to finalizing a proposed rule that will update payment rates under the Medicare physician fee schedule for 2004. The proposed rule also revises a number of policies affecting Medicare Part B payments under the fee schedule.

The physician fee schedule specifies payment rates to physicians and other providers for more than 7000 healthcare services and procedures, ranging from simple office visits to complex surgeries. In calendar year 2004, Medicare is expected to pay approximately $48.7 billion to 900,000 physicians and other suppliers for services paid under the fee schedule. In 2003, CMS paid $47.9 billion in services.

In an effort by CMS to improve medical care for beneficiaries with end-stage renal disease (ESRD), CMS is proposing to create new codes that would allow Medicare to align payment for physician oversight dialysis services with the frequency of physician visits. Medicare currently pays a composite rate to physicians for medical oversight without regard to the patient’s condition or the number of times the physician sees the patient. CMS understands that physician involvement in dialysis for ESRD varies on the basis of the patient’s condition and response to dialysis, and the presence of other acute or chronic conditions. In addition, a physician’s involvement with a single patient may vary from month to month. The proposed codes are intended to ensure that beneficiaries with ESRD receive the highest quality dialysis care available and that physician involvement in dialysis for ESRD patients is appropriate and consistent with the needs of the patient in any month.

The proposed rule was published in the August 15^th Federal Register. CMS accepted comments on the proposals until October 7 and will publish a final rule later this year.

Possible Senate Finance Committee Hearing on ESRD

Senate Finance Committee Chairman Charles Grassley (R-Iowa) will likely hold a hearing in mid to late October that will focus on ESRD. Specifically, Chairman Grassley wants to focus on quality, monitoring, and enforcement issues at ESRD facilities. The October hearing would be a follow-up to the 2000 Senate Special Committee on Aging ESRD hearing. The hearing will coincide with the release of a Government Accounting Office (GAO) report requested by Senator Grassley that highlights the issues surrounding the ever-changing dialysis facility environment.

ASN and other renal organizations and for-profit dialysis groups participated in the planning of the hearing. The Senate Finance Committee is particularly interested in learning about components of quality, quality measures and outcomes, common standards for reporting, workforce issues, access/health disparities, funding for site visits, and accountability measures for facilities. The Senate Finance Committee is interested in kidney disease/ESRD because the CMS is attempting to standardize ESRD quality measures and quality care initiatives.