US SB2730

Extends the Transitional Drug Add-on Payment Adjustment (TDAPA) period from 2 years to at least 3 years for new renal dialysis drugs and biological products approved by the FDA on or after January 1, 2020, with changes effective January 1, 2026

Creates a permanent post-TDAPA add-on payment adjustment set at 65% of calculated drug expenditures, updated annually for inflation and implemented outside budget neutrality requirements

Extends the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) to at least 3 years and makes FDA breakthrough devices eligible for this payment adjustment beginning January 1, 2026

Requires Medicare Advantage plans to make direct payments to dialysis providers for innovative drugs, biologicals, and equipment receiving transitional payment adjustments, matching amounts under the ESRD prospective payment system

Establishes a forecast error adjustment to the ESRD market basket payment update beginning in 2026, triggered when the difference between forecasted and actual price changes exceeds 0.5 percentage points, with the initial adjustment accounting for cumulative forecast error from 2021-2022