End-Stage Renal Disease Network Organizations' Reported Actions Taken in Response to the COVID-19 Pandemic

Why OIG Did This Audit

End-stage renal disease (ESRD) is a medical condition in which a person's kidneys permanently cease functioning, leading to the need for a regular course of long-term dialysis or a kidney transplant. The Centers for Disease Control and Prevention has reported that beneficiaries with serious underlying medical conditions, such as ESRD, are at a higher risk for severe illness from COVID-19.

Our objective was to identify what actions the ESRD Network Organizations (Network Organizations) took during the COVID-19 pandemic to: (1) aid dialysis clinics and patients and (2) keep the Centers for Medicare & Medicaid Services (CMS) informed about quality-of-care issues.

How OIG Did This Audit

Our findings are based on responses to a questionnaire and follow-up interviews with the 18 Network Organizations that represent geographic areas within the ESRD Network program. The questionnaire and interviews focused on Network Organization responsibilities during the COVID-19 pandemic (pandemic). We obtained evidence on Network Organization actions to provide aid and keep CMS informed during the pandemic. We also interviewed officials at CMS ESRD contractors and Federal agencies to gain an understanding of their roles and reviewed Network Organizations' reports submitted to CMS during the pandemic.

What OIG Found

The 18 ESRD Network Organizations that we surveyed provided information about the actions they took to aid dialysis clinics and patients and keep CMS informed about quality-of-care issues that arose during the COVID-19 pandemic. Network Organizations also reported to us challenges they encountered in taking those actions during the pandemic.

Despite the unprecedented challenges faced by the Network Organizations during the pandemic, they took actions to ensure continuity of services in a safe manner for high-risk ESRD beneficiaries. Network Organizations served a key role in addressing the additional demands on dialysis clinics during the pandemic through actions such as: (1) disseminating changing guidance, (2) aiding dialysis clinics to address the increased concerns and grievances related to the pandemic, and (3) promoting safe alternative treatment options. Network Organizations also kept CMS informed of quality-of-care issues by communicating through established communication processes and processes modified for better use during the pandemic.

What OIG Recommends

We are providing this information to help CMS identify Network Organizations' actions taken and challenges faced during the COVID-19 pandemic to assist in planning for future public health emergencies; therefore, this report does not contain any recommendations.