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Dialysis Patient Advocates Seek Restraining Order Against CMS

2024-03-29T01:13:41+00:00January 9th, 2017|Categories: Access to Transplant, Care Coordination, Charitable Premium Assistance, Medigap Coverage, Press Release, State Advocacy|

Lawsuit charges that CMS rule to take effect Jan. 13 gives insurers illegal veto power over access to private coverage Washington, D.C. – Advocates for dialysis patients filed suit in federal court today to prevent the U.S. Department of Health and Human Services (HHS) from enforcing a rule that could force patients off their current health plans and jeopardize their access to care. The regulation, which the Centers for Medicare and Medicaid Services (CMS) issued Dec. 13 outside the formal rulemaking process, gives insurers the power to prevent dialysis patients from receiving charitable premium assistance that makes it possible for [...]

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Protecting Dialysis Patients’ Health Coverage

2024-03-29T01:13:41+00:00January 9th, 2017|Categories: Access to Transplant, Blog, Care Coordination, Charitable Premium Assistance, Legal Defense, Medigap Coverage|Tags: |

By Hrant Jamgochian, CEO Dialysis Patient Citizens Across the country, thousands of patients with end-stage renal disease (ESRD) face the agonizing choice of paying for necessities such as rent and food, or paying the insurance premiums that enable them to get dialysis and other critical care. Fortunately, ESRD patients have options. Thanks to federal law, they can enroll in Medicare at any age. Or, if they would rather keep a private insurance plan, they can apply for financial help from charities such as the American Kidney Fund. These payments are a lifeline that enables patients to maintain their existing coverage and [...]

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Dialysis Patients Outraged by CMS Move Giving Insurers Illegal Veto Power Over Access to Private Coverage

2024-03-29T01:13:41+00:00December 19th, 2016|Categories: Access to Transplant, Care Coordination, Charitable Premium Assistance, Legal Defense, Medigap Coverage, Press Release|

Dialysis Patient Citizens says CMS rule tacitly allows insurers to discriminate based on patients’ health condition Washington, D.C. – Advocates for dialysis patients are outraged by an interim final rule issued late yesterday by the Centers for Medicare and Medicaid Services (CMS) that could force patients off their current health plans and jeopardize their access to care. The rule, which CMS wrote with the stated purpose of ensuring that dialysis patients receive accurate information about their health coverage options, instead empowers insurers to prevent those patients from receiving charitable premium assistance that makes their health insurance affordable. “The administration is [...]

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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 Files Legal Complaint with the Office of Civil Rights over Discrimination by Blue Cross Idaho

2024-03-29T01:50:29+00:00June 6th, 2016|Categories: Article, Charitable Premium Assistance, Legal Defense, State Advocacy|

On behalf of kidney patients nationally, Dialysis Patient Citizens (DPC) filed a legal complaint with the U.S. Department of Health and Human Services’ Office of Civil Rights citing discriminatory behavior by Blue Cross Idaho (BCI) against individuals with kidney failure, a disease which disproportionately impacts minorities. The complaint involves a new BCI policy guideline, targeting policyholders with kidney failure who need three times weekly dialysis to live. Under the policy, BCI screens policyholders with kidney failure to determine how their premiums are paid and dumps individuals who receive financial assistance from the non-profit, federally approved charity, American Kidney Fund (AKF). The non-profit DPC, the nation’s [...]

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Re: Discrimination Against End-Stage Renal Disease Patients by Health Net

2024-03-29T01:50:29+00:00May 3rd, 2016|Categories: Charitable Premium Assistance, Comment Letter, Private Insurance Coverage, State Advocacy|

Janice Rocco California Department of Insurance 300 Capitol Mall Suite 1700 Sacramento, CA 95814 Mary Watanabe Department of Managed Health Care (DMHC) 980 9th Street, Suite 500 Sacramento, CA 95814 Re: Discrimination against end-stage renal disease patients by Health Net Dear Deputy Commissioner Rocco and Deputy Director Watanabe: With 29,000 dialysis patient members, over 4,000 of whom reside in California, Dialysis Patient Citizens (DPC) is the nation’s largest patient-led organization representing individuals with end-stage renal disease (ESRD). On behalf of California’s 84,500 ESRD patients, I want to thank you for meeting with us to discuss the Health Net matter, which [...]

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

2024-03-29T01:50:31+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, [...]

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