HB 75, as is, will end affordable, life-saving kidney care in NM
Lumping clinics with hospitals makes liability coverage unavailable
Renal Medicine Associates is a single-specialty nephrology practice established in 1973 in Albuquerque. We provide comprehensive care for patients with kidney disease throughout central, eastern and southern New Mexico, with locations in Albuquerque, Roswell, Las Cruces, Socorro and Clovis. Our complete range of kidney-care services not only covers the spectrum of kidney disease including acute and chronic kidney disease, hypertension, kidney stones, in-center and home dialysis, but also a vascular access center and robust clinical research. We also partner with Presbyterian Hospital to provide the only kidney-pancreas transplant and one of two kidney transplant programs in New Mexico. Renal Medicine Associates is dedicated to the highest quality of care in the prevention and treatment of kidney disease and maintenance of kidney health.
We provide life-sustaining dialysis services to more than 1,000 patients with end-stage renal disease (ESRD). While most medium and large renal practices in the nation lost 5% to 10% of their patients during COVID, due to early roll out of Tele Medicine and preventative measures, we lost very few and grew at the 3% to 5% rate. We have 13 physicians and 16 physician extenders in our group and have been able to attract providers from the best training programs — till now.
Recent changes in medical liability laws in New Mexico are making it harder for us to continue to provide best care to New Mexico residents. We are having difficulty recruiting new providers, who prefer now to practice in Texas, Arizona and Colorado. Our liability coverage premiums have gone up. State income tax and GRT on revenues also make it less appealing for new providers.
RMA operates Valley Home Dialysis in Las Cruces, which is the only home dialysis standalone facility of its kind in southern New Mexico. Medicare guidelines for dialysis options in ESRD patients strongly recommended going with the home-dialysis option, with the aim of 50% of ESRD patients receiving home dialysis or transplant by 2025. With the new rule, we are supposed to have a coverage of $4 million for liability. We have not been able to find such coverage and will be forced to shut down a unique clinic by end of 2023 — unless such facilities owned by independent doctors are not excluded from HB 75 provisions.
RMA is also planning on starting an outpatient surgical center for providing comprehensive care for vascular access and home dialysis catheter placements. This was in the advanced stages of planning before passage of HB 75. We cannot find liability coverage for the facility. Doing these procedures as outpatient is cheaper for the health care system and more efficient. Patients will have limited access to hospital-based centers. Hospitals are overloaded with patients, and delay in such procedures is associated with poor outcome including ER visits, hospitalizations and death.
HB 75’s provisions will result in shutting down of several facilities that provide life-sustaining care for the people of New Mexico, drive up health care costs, result in frivolous claims against physicians and affected facilities and ultimately lead to an exodus of physicians and practices from the state of New Mexico. Is this what we seek?
New Mexicans who are wealthy or have insurance policies that cover care out of state are already going to other states for medical care. We should support a health care system that can provide such care to New Mexicans here.
RMA doctors strongly oppose HB 75’s provision of including independently owned health care facilities/centers with hospital owned units for the increased liability coverage. It will lead to poor health care delivery by independent doctors who form the backbone of a fragile health care system in New Mexico.