In January 2025, a quiet but consequential Medicare rule change redefined how dialysis patients access a critical class of medications. Nephrologists for Equitable Kidney Care (NEKC) and the American Society of Consultant Pharmacists (ASCP) are hearing stories from nephrologists and pharmacists nationwide. Fortunately, a long-term care pharmacist identified the issue and dispensed a short-term supply of sevelamer at the facility’s cost to ensure continuity of care. A call for changeNEKC was founded to amplify the voices of those too often left behind in kidney care. The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.