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Annual Medicare ESRD Rule Highlights Innovation and “Meaningful Measures”

2024-03-29T01:13:39+00:00July 16th, 2018|Categories: Article, Innovation, Quality Incentive Program|

Last week, the Centers for Medicare & Medicaid Services (CMS) proposed what they called “innovative changes” to the payment rule for the End-Stage Renal Disease (ESRD) program. The rule includes a “proposal to address new renal dialysis drug and biological costs and foster innovations in treatment by incentivizing new therapies for patients on dialysis and a proposal to reduce facility-related documentation burden.” It contains the first changes to the ESRD Quality Incentive Program (QIP) since last year’s announcement of CMS’ “Meaningful Measures” Initiative. Funding for Dialysis The proposed 2019 ESRD base rate is $235.82, an increase of $3.45 to the current [...]

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CMS Releases Proposed Payment Rule for 2018

2024-03-29T01:13:40+00:00July 19th, 2017|Categories: Article, Innovation, Quality Incentive Program|

On June 29, the Centers for Medicare & Medicaid Services (CMS) issued its proposed Annual Payment Rule for the End-Stage Renal Disease (ESRD) Program to govern dialysis services furnished beginning January 1, 2018. The proposed rule also makes minor changes to the ESRD Quality Incentive Program (QIP). This year’s rule includes an increase to the base rate, replacing QIP measures as well as including social risk factors in the QIP scores. CMS says the ESRD proposed rule is “one of several rules for 2018 that reflect a broader Administration-wide strategy to relieve regulatory burdens for providers; support the patient-doctor relationship [...]

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Comments to CMS re: Request for Information on Insurance Steering

2024-03-29T01:50:28+00:00September 20th, 2016|Categories: Charitable Premium Assistance, Comment Letter, Innovation|

Andrew Slavitt, Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, SW Washington, D.C. 20201 Re: CMS-6074-NC: “Request for Information: Inappropriate Steering of Individuals Eligible for or Receiving Medicare and Medicaid Benefits” Dear Mr. Slavitt: Dialysis Patient Citizens (DPC) responds herein to the Centers for Medicare and Medicaid Services (CMS) with comments on the above referenced Request for Information. As America’s largest patient-led organization representing dialysis patients, DPC’s membership consists of more than 28,000 dialysis and pre-dialysis patients and their families. We seek to ensure the patient point [...]

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DPC Complaint to OFM re: Washington State Insurance Plans

2024-03-29T01:50:28+00:00July 19th, 2016|Categories: Charitable Premium Assistance, Comment Letter, Innovation, Private Insurance Coverage, State Advocacy|

Re: Violations of the Medicare Secondary Payer Statute, 42 U.S.C. § 1395y(b), by Washington State Health Insurance Plans Dear Ms. Parker and Ms. Dotzel: We write to bring to your attention the fact that at least three group insurers in the state of Washington are offering large plans with provisions that violate the explicit terms of the Medicare Secondary Payer Statute. These violations not only potentially subject the insurers to statutory civil monetary penalties, but render these insurers’ plans nonconforming under applicable regulations. As America's largest patient-led organization representing 29,000 dialysis patients and family members, Dialysis Patient Citizens (DPC) strives to [...]

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DPC Complaint to Department of Labor re: Insurance Plan Discrimination

2024-03-29T01:50:29+00:00June 28th, 2016|Categories: Charitable Premium Assistance, Comment Letter, Innovation, Private Insurance Coverage|

The Honorable Phyllis C. Borzi Assistant Secretary Employee Benefits Security Administration United States Department of Labor 200 Constitution Ave NW Washington, DC 20210 Re: Violations of Part 7 of the Employee Retirement Income Security Act Relating to Health Plans’ Treatment of End-Stage Renal Disease Dear Assistant Secretary Borzi: On behalf of the 29,000 dialysis patients and family members that we serve, Dialysis Patient Citizens (DPC) asks that the Employee Benefits Security Administration (EBSA) investigate activities some group health plans have undertaken that we believe discriminate against individuals with kidney failure in violation of Part 7 of the Employee Retirement Income Security [...]

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Study: End Stage Renal Disease Patients Face Policy Barriers to Home Dialysis

2024-03-29T01:50:30+00:00March 10th, 2016|Categories: Improve Access to Care, Increase Quality of Care, Innovation, Promote Financial Security, Treatment Options|

Current federal policies limit patient access to home dialysis, a treatment option that offers significant clinical and quality-of-life advantages, according to a report released today by Washington, DC-based economist Alex Brill of Matrix Global Advisors (MGA). As a result of policy barriers, Brill finds a key segment of the growing population of patients who have end-stage renal disease (ESRD) miss out on the important health and lifestyle benefits of home dialysis. Brill, formerly chief economist to the House Ways & Means Committee, also finds that innovation in the home dialysis market may not reach patients if barriers cannot be addressed. Fewer [...]

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2015 Year in Review

2024-03-29T01:50:30+00:00January 19th, 2016|Categories: 5-Star Ratings, Access to Transplant, Article, Care Coordination, Charitable Premium Assistance, Dialysis Funding, Innovation, Medicare Advantage|Tags: |

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 [...]

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DPC Joins Kidney Community in Requesting Meeting with CMS on ESCOs

2024-03-29T02:08:58+00:00June 26th, 2013|Categories: Care Coordination, Comment Letter, Innovation|

Dear Ms. Tavenner and Dr. Gilfillan: On behalf of the undersigned organizations, thank you for your leadership of the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI). Together, our organizations represent the patients, physicians, nurses, scientists, and other health professionals dedicated to advancing excellence in the care of patients with kidney disease. Foremost among our shared goals is continuous improvement in the quality, efficiency, and accessibility of care available to patients with kidney disease. Our organizations applaud the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center’s establishment of [...]

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Update: Dialysis Care Coordination Moves Forward!

2024-03-29T02:08:59+00:00March 19th, 2013|Categories: Blog, Care Coordination, Innovation|

By Jessica N., Director of Public Affairs As I highlighted last fall, DPC has been busy working with other kidney community organizations and the federal government on a new and improved way to provide care to dialysis patients. As part of recent health care reform efforts, Medicare has been developing new ways to coordinate care for various patient groups and they just came out with their dialysis specific program! Medicare, or more specifically the Centers for Medicare and Medicaid Innovation (CMMI), released the official blueprint for this new program, which they have called the Comprehensive ESRD Care Initiative. The initiative is [...]

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