The Medicare End Stage Renal Disease (ESRD) Program, a national health insurance program for people with end stage renal disease, was established in 1972 with the passage of Section 299I of Public Law 92-603. The formation of ESRD Network Organizations was authorized in 1978 by Public Law 95-292 which amended Title XVIII of the Social Security Act by adding section 1881. Thirty-two ESRD Network areas were initially established. H.R. 8423 was designed to encourage self-care dialysis and kidney transplantation and clarify reimbursement procedures in order to achieve more effective control of the costs of the renal disease program. In 1986, the Omnibus Budget Reconciliation Act of 1986 (P.L. 99-509) amended section 1881c of the Social Security Act to establish at least 17 ESRD Network areas and to revise the Network Organizations responsibilities.

Today, eighteen (18) ESRD Network Organizations exist under contract to CMS and serve as liaisons between the federal government and the providers of ESRD services. The Network Organizations are defined geographically by the number and concentration of ESRD beneficiaries in each area. Some Networks represent one state, others multiple states. The ESRD Network Organizations' responsibilities include: the quality oversight of the care ESRD patients receive, the collection of data to administer the national Medicare ESRD program, and the provision of technical assistance to ESRD providers and patients in areas related to ESRD.

All ESRD Networks are members of the Forum of ESRD Networks, which is a not-for-profit organization that advocates on behalf of its membership and coordinates projects and activities of mutual interest to ESRD Networks. The Forum facilitates the flow of information and advances a national quality agenda with CMS and other renal organizations.


The National Forum of ESRD Networks, Inc. is a registered 501(c)(3) non-profit organization #13-3246354. Your donation is tax deductible to the extent allowable by law. No goods or services will be provided by the Forum in return or consideration for this contribution. Donations can also be mailed to the Forum Office at PO Box 70623, Henrico, VA 23255.

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What's new on the Forum website?

MAC Releases Updated Home Dialysis Toolkit

This toolkit for health providers and practitioners is a reference tool that gives information about overcoming barriers to starting or growing a home dialysis program.

NEW: Home Dialysis Toolkit [2023]

Updated to include:

  • New sections to address AAKH and CfC updates
  • Emergency management of home dialysis patients
  • Impact of ESCOs, ETC Model, Voluntary Models on home therapies
  • Enhanced modality education: transitional care and self care
  • Emerging Technology and the impact and benefits to home therapies
  • Addressing Disparities and Access to Care
  • Home therapy options in the LTC/nursing home setting
  • KPAC Section: Empowering patients and care partners to be successful at home

Read the press release here.

Latest Forum Matters Now Available

The latest Forum Matters Newsletter is now available on the website!

Review current and past issues of Forum Matters here.

MAC Updates Transitions of Care Toolkit

This Toolkit for health providers and practitioners is a reference tool that gives information about challenges in transitions of care and suggestions to help create solutions.

MAC Transitions of Care Toolkit (March 2022)

COVID-19 Vaccination Flyer for Dialysis Patients

Please share this flyer with your dialysis patients

Resources & Links for Kidney Patients

Learn about the New Transplant Toolkit for Patients

This 12-minute video provides an overview of the Toolkit

Is A Kidney Transplant Right for Me?

Project Makefile