Berkley's efforts for kidney care raise questions

WASHINGTON – Democratic Rep. Shelley Berkley's efforts to influence federal reimbursement rates for dialysis providers and to save a kidney transplant program in her home state of Nevada have raised questions about an appearance of a conflict of interest with her husband's medical practice.

But an ethics watchdog group said Tuesday the efforts are unlikely to generate further investigation because her work helped a large swath of health providers, not just her husband.

Berkley, who is running for the Senate, was the focus of a New York Times report that examined her role in staving off the closure of the state's only kidney transplant center. Her husband, Dr. Larry Lehrner, has a nephrology practice that administers kidney care at the University Medical Center in Las Vegas.

Federal regulators had moved three years ago to shut the kidney transplant program because kidney transplants were failing at unusually high rates, but Berkley and other members of Nevada's congressional delegation intervened and succeeded in gaining a reprieve.

The department's closure would have required Nevadans to go out of state for a kidney transplant.

"I think going to bat for the hospital, it's really hard for me to see that as a big conflict," said Melanie Sloan, executive director of Citizens for Responsibility and Ethics in Washington. "The concept of closing the only transplant center in the entire state, that seems like a big deal, and it seems like any member of Congress would have to be involved, plus she didn't initiate it, so it just doesn't bother me very much."

The Times also noted that Berkley led recent congressional efforts opposing a 3.1 percent cut in funding for dialysis treatment and that she warned an influential colleague, Rep. Pete Stark of California, to move carefully in considering changes in compensating doctors who provide dialysis treatments. Lehrner operates a dozen dialysis centers in Nevada.

Sloan said she found Berkley's efforts on reimbursement rates to be more troubling, but not to the point that it could spawn an inquiry.

"The conflicts rules make clear that unless you're involved in something that is almost a personal benefit, a private benefit, you're pretty much allowed to do it," Sloan said.

Berkley's campaign on Tuesday stressed that the University Medical Center reached out to all the state's representatives, not just her.

"I will never stop fighting on behalf of my constituents just because my husband is a doctor," Berkley said in a prepared statement.

The campaign said she has advocated for several health care specialists, not just dialysis providers.

"Nevada is ranked 48th in doctors per patient and for areas of specialized care, the state ranks dead last," said Berkley's campaign manager, Jessica Mackler. "In addition, doctors are increasingly refusing to take Medicare patients, reducing access to care for Nevada seniors. That is why Shelley Berkley has fought to stop measures that would make it even harder for elderly and sick patients in Nevada to see a good doctor who will provide high-quality care."

Republican strategists seized on the report, indicating the GOP may try to use it as an issue in next year's Nevada Senate race. Berkley is expected to win the state's Democratic primary and run against Sen. Dean Heller, a Republican appointed to the seat when Sen. John Ensign resigned in the wake of an extramarital affair with a campaign aide.

Heller also was part of the delegation that fought to keep the kidney transplant program open. A Heller spokesman did not return phone calls seeking comment.

The hospital has conducted 31 kidney transplants so far this year.

A spokesman for Senate Majority Leader Harry Reid said he did not believe Berkley did anything wrong.

"Shelley Berkley has Senator Reid's full support in her bid to represent Nevada in the United States Senate," said spokesman Zac Petkanas.

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Associated Press writer Cristina Silva in Las Vegas contributed to this report.