Improve Access to Care Archives - Page 13 of 17

2015 Year in Review

Hannah Bracamonte2024-03-29T01:50:30+00:00January 19th, 2016|Categories: 5-Star Ratings, Access to Transplant, Article, Care Coordination, Charitable Premium Assistance, Dialysis Funding, Innovation, Medicare Advantage|Tags: Annual Accomplishments|

Happy New Year! In 2015, DPC leadership and its strong patient advocacy efforts at the state level fought to: prevent dramatic cuts to dialysis funding in Alabama and Illinois and preserve charity payments for dialysis patient premiums. Other highlights include: The opportunity for DPC CEO Hrant Jamgochian and board member Bob Lee to testify in front of the Oregon insurance commissioner on the discriminatory language found in two private insurance plans that would limit coverage for ESRD patients. The commissioner ruled against the language. DPC board member Danny Iniguez discussed health disparities in kidney disease at the National Black Caucus [...]

DPC Urges CMS to Prioritize Patient Access

Hannah Bracamonte2024-03-29T01:50:30+00:00January 19th, 2016|Categories: Access to Transplant, Care Coordination, Charitable Premium Assistance, Medicare Advantage, Medigap Coverage, Transportation Services|Tags: Health Insurance Exchange|

Last month, DPC sent a letter commenting on the “Notice of Benefit and Payment Parameters for 2017” proposed rule. This annual rule by the Centers for Medicare and Medicaid Services (CMS) contains proposed changes to the exchange plan coverage of the Affordable Care Act. DPC’s letter focuses on the importance of insurance coverage and network quality for end-stage renal disease (ESRD) patients. One issue the letter comments on pertains to network adequacy. Network adequacy describes an insurance plan’s ability to provide a sufficient amount of in-network providers to subscribers in the plan. Suggestions to improve network adequacy include requiring all [...]

RE: CMS–9937–P: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017

Hannah Bracamonte2024-03-29T01:50:31+00:00December 21st, 2015|Categories: Advance Patient Choice, Charitable Premium Assistance, Comment Letter, Improve Access to Care|Tags: Health Insurance Exchange|

Andrew Slavitt Acting AdministratorCenters for Medicare and Medicaid Services 7500 Security BoulevardBaltimore, MD 21244RE: CMS–9937–P: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017Dear Acting Administrator Slavitt,On behalf of the more than 430,000 patients who rely upon dialysis services, we appreciate the opportunity to comment on the “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017” Proposed Rule (Proposed Rule). We strongly encourage the Centers for Medicare and Medicaid Services (CMS) to protect the rights of all Americans to access coverage in the Marketplaces, consistent with the Affordable Care [...]

CMS to Expand Prior Authorization of Transportation Services to Six More States

Hannah Bracamonte2024-03-29T01:50:31+00:00November 9th, 2015|Categories: State Advocacy, Transportation Services|

The Centers for Medicare and Medicaid Services (CMS) will begin expanding a prior authorization model for non-emergency ambulance transportation for dialysis patients into six states: Maryland, Delaware, the District of Columbia, North Carolina, Virginia and West Virginia. The program expansion will begin on January 1, 2016 and requires ambulance providers in those states to obtain documentation from physicians prior to beginning service. CMS plans to reach out to ambulance providers and Medicare beneficiaries about the program through educational materials. This model was originally implemented in New Jersey, Pennsylvania and South Carolina. It came in response to fraud cases found in those states, [...]

New ACO Model Focuses on ESRD Patient Care

Hannah Bracamonte2024-03-29T01:50:31+00:00October 9th, 2015|Categories: Article, Care Coordination|

The Centers for Medicare & Medicaid Services (CMS) has announced the participants for the Comprehensive ESRD Care (CEC) Model, a new accountable care organization (ACO) model designed specifically for ESRD patients. ACOs are groups of physicians and other health care providers who collectively take on responsibility for the quality and cost of care for a population of patients. In the CEC Model, dialysis facilities, nephrologists and other providers have formed ESRD Seamless Care Organizations (ESCOs) to coordinate care for ESRD beneficiaries. ESCOs will be financially accountable for quality outcomes and Medicare Part A and B spending, including all spending for dialysis [...]

ESRD Seamless Care Organizations FAQ’s

Hannah Bracamonte2024-03-29T01:50:31+00:00October 7th, 2015|Categories: Care Coordination, Other Links|

Re: Essential Health Benefits – 2017 Benchmark Plans

Hannah Bracamonte2024-03-29T01:50:32+00:00September 28th, 2015|Categories: Care Coordination, Comment Letter, Promote Financial Security|Tags: Health Insurance Exchange|

Hon. Kevin Counihan Center for Consumer and Information and Insurance Oversight Centers for Medicare and Medicaid Services Hubert H. Humphrey Building 200 Independence Ave, SW Washington, D.C. 20201 Re: Essential Health Benefits - 2017 Benchmark Plans Dear Deputy Director Counihan: Dialysis Patient Citizens, America’s largest patient-led organization representing dialysis patients, is comprised of more than 28,000 dialysis and pre-dialysis patients and their families. We seek to ensure the patient point of view is considered by policy makers. We are writing to comment on the Agency’s List of Proposed 2017 Essential Health Benefits (EHB) Benchmark Plans. States have four options for [...]

Letter to Oregon Insurance Commissioner Emphasizes Importance of Private Insurance
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Letter to Oregon Insurance Commissioner Emphasizes Importance of Private Insurance

Hannah Bracamonte2024-03-29T01:50:32+00:00September 16th, 2015|Categories: Article, Charitable Premium Assistance, Comment Letter, Improve Access to Care, Promote Financial Security, State Advocacy|Tags: Health Insurance Exchange|

Regence and Moda, two private insurance plans in Oregon, recently made changes to their 2016 plans that would negatively affect ESRD patients. Specifically, after three months of coverage, any out-of-pocket payments patients make for dialysis treatment will no longer count towards their out-of-pocket maximums. This appears to be an effort to pressure dialysis patients to drop their private coverage and enroll in Medicare. DPC’s letter to the Oregon Insurance Commissioner calls attention to this discriminatory move. Medicare plans do not include an out-of-pocket maximum amount, while most private insurance plans do. Statistics also show that patients with Medicare plans are [...]

Representative Pitts visits Reading Dialysis Center

Hannah Bracamonte2024-03-29T01:50:32+00:00September 16th, 2015|Categories: Article, Care Coordination, Dialysis Funding, Medicare Advantage, Promote Financial Security|

During the August recess, Congressman Joe Pitts took the opportunity to engage with dialysis patients in his home district. He recently visited the Reading Dialysis Center in Reading, PA where he received a tour of the facility and met with dialysis nurses and staff. As Chairman of the Energy and Commerce Health Subcommittee, he is an influential decision maker when it comes to kidney care issues. He spoke to the dialysis staff on a variety of health proposals currently in Congress including the 21st century Cures initiative. We hope Representative Pitts will continue his support of kidney care issues by co-sponsoring [...]

Biosimilar Medication Topic of House Letter to CMS

Hannah Bracamonte2024-03-29T01:50:32+00:00August 14th, 2015|Categories: Improve Access to Care, Increase Quality of Care, Promote Financial Security|

When the FDA approves a generic drug, it’s based on the chemicals contained in the original brand medication. Congress recently enacted a similar process for the approval of “biosimilars” based on the original biologic medication. The main difference is that the “biosimilar” is approved based on its development process. Biosimilars have the potential to be a cheaper alternative for expensive biologic medications such as Epogen, a drug used for anemia management. A letter sent from the House of Representatives to the Centers for Medicaid and Medicare Services (CMS) calls attention to a biosimilar reimbursement proposal in CMS’s 2016 Medicare Physician Fee Schedule proposed [...]

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