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Centers for Medicare and Medicaid Services Crack Down on New Jersey Ambulance Companies that Fraudulently Bill Medicare

2024-03-29T01:50:33+00:00May 14th, 2015|Categories: Article, State Advocacy, Transportation Services|

The Centers for Medicare and Medicaid Services (CMS) is continuing a four-month crackdown on Medicare fraud in New Jersey. CMS has accused ambulance companies of fraudulently billing Medicare for transporting patients to non-emergency dialysis, chemotherapy and wound care. CMS found that these ambulance trips in New Jersey were twice the national average (from 2002 to 2011), and that the number of trips per patient was up approximately 60%. At least 11 ambulance companies report closing in recent months. The ambulance companies in New Jersey are now required to obtain pre-authorization from Medicare to transport a given patient, and many of [...]

DPC Urges Arizona to Maintain Medicaid Reimbursement for Dialysis

2024-03-29T01:50:34+00:00February 27th, 2015|Categories: Comment Letter, Medicaid, State Advocacy|

Governor Doug Ducey 1700 West Washington St. Phoenix, AZ 85007 RE: Proposed Cuts to Medicaid Coverage Dear Governor Ducey, As America’s largest patient-led organization representing over 28,000 members, Dialysis Patient Citizens (DPC) works to improve the quality of life of all dialysis patients through education and advocacy. Dialysis is a life-sustaining care delivered to over 12,400 patients in Arizona who have End-Stage Renal Disease (ESRD), also known as kidney failure. For those with ESRD, receiving regular dialysis or a kidney transplant are the only treatments that allow patients to continue living. The number of individuals with kidney failure continues to [...]

Prior Authorization of Non-Emergency Ambulance Transportation to Begin for Dialysis Patients in New Jersey, Pennsylvania and South Carolina

2024-03-29T01:50:34+00:00November 13th, 2014|Categories: State Advocacy, Transportation Services|

The Centers for Medicare & Medicaid Services (CMS) will begin implementing a prior authorization demonstration program for non-emergent ambulance transport of dialysis patients in New Jersey, Pennsylvania and South Carolina. CMS believes using a prior authorization process will help ensure services are provided in compliance with Medicare coverage rules, specifically that ambulance providers in those states must obtain documentation from physicians prior to the beginning of service. The requirement does not apply to hospital-based ambulances. CMS is taking these actions in response to instances of fraud in those three states. For example, one Pennsylvania fraud scheme involved more than $3.6 [...]

DPC to Host Regional Meetings

2024-03-29T02:08:04+00:00September 3rd, 2014|Categories: Article, State Advocacy, Treatment Options|

DPC is excited to announce the beginning of a new program to further engage kidney disease patients through education and advocacy. For the first time ever, DPC is hosting four regional meetings in sites around the country to bring dialysis patients together to engage on issues important to their care and well-being. The inaugural locations for these regional meetings are as follows: Detroit, Michigan; Seattle, Washington; Houston, Texas and New York, New York. We have partnered with the American Psychological Association to provide an informative and engaging session on the importance of having good mental health as a kidney disease [...]

Kidney Community Rallies for Key Victory in Louisiana

2024-03-29T02:08:05+00:00June 3rd, 2014|Categories: Article, Charitable Premium Assistance, State Advocacy|

Recently, Blue Cross Blue Shield stopped accepting third party payments for medical premiums in the new health exchanges. This meant that dialysis patients in the state of Louisiana could not use financial assistance from organizations such as the American Kidney Fund (AKF) to subsidize their premium costs. Nearly 2,000 low-income Louisiana dialysis patients rely on help from assistance organizations to maintain their access to health insurance. For people with kidney failure, the out-of-pocket treatment costs are very high, and it is particularly challenging for a person on dialysis to remain employed because of the frequent treatment schedule (typically three times [...]

Medicare Ambulance Fraud in Los Angeles – A Specific Example

2024-03-29T02:08:05+00:00May 7th, 2014|Categories: Article, State Advocacy, Uncategorized|

The owners of Alpha Ambulance Inc. (Alpha), a now-defunct Los Angeles-area ambulance transportation company, have been sentenced in connection with a Medicare fraud scheme. Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, U.S. Attorney André Birotte Jr. of the Central District of California, Special Agent in Charge Glenn R. Ferry of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Director in Charge Bill L. Lewis of the FBI’s Los Angeles Field Office made the announcement. Aleksey Muratov, aka Russ Muratov, 32, and Alex [...]

Re: Support for S.B. 403

2024-03-29T02:08:06+00:00May 1st, 2014|Categories: Charitable Premium Assistance, Comment Letter, State Advocacy|

Louisiana House Insurance Committee 900 North Third Street Baton Rouge, LA 70804 Re: Support for S.B. 403 Dear Chairman Cromer and Committee, As America’s largest patient-led organization representing over 27,000 members, Dialysis Patient Citizens (DPC) works to improve the quality of life of all dialysis patients through education and advocacy. Today we are writing on behalf of the over 6,000 dialysis patients in Louisiana to support S.B. 403, which allows third-party payments for premiums. BlueCross Blue Shield of Louisiana (BCBSLA) recently instituted a new policy of no longer accepting thirdparty payments for premiums. We believe this policy is detrimental to [...]

Re: Discrimination Against Dialysis Patients by BlueCross Blue Shield of Louisiana

2024-03-29T02:08:06+00:00April 8th, 2014|Categories: Charitable Premium Assistance, Comment Letter, State Advocacy|Tags: |

Phyllis Borzi, Assistant Secretary Employee Benefits Security Administration Department of Labor Washington, DC John P. Albert, Director Division of Medicare Secondary Payer Policy Centers for Medicare and Medicaid Services Baltimore, MD Re: Discrimination against dialysis patients by BlueCross Blue Shield of Louisiana Dear Ms. Borzi and Mr. Albert: As America’s largest patient-led organization representing over 27,000 members, Dialysis Patient Citizens (DPC) works to improve the quality of life of all dialysis patients through education and advocacy. Today we are writing on behalf of the over 6,000 dialysis patients in Louisiana to request inquiries into the new BlueCross Blue Shield of [...]

DPC Thanks Texas for Allowing ESRD Patients to Purchase Medigap Plans

2024-03-29T02:08:07+00:00January 27th, 2014|Categories: Comment Letter, Medigap Coverage, State Advocacy|

Ms. Sara Waitt, General Counsel Texas Department of Insurance P.O. Box 149104 Austin, TX 78714-9104 Re: Minimum Standards for Medicare Supplement Policies Dear Ms. Waitt, As America’s largest patient-led organization representing dialysis patients, Dialysis Patient Citizens (DPC) works to improve the quality of life of all dialysis patients through education and advocacy. Today we are writing on behalf of over 37,000 dialysis patients in Texas, specifically those who use the Texas Health Insurance Pool for supplemental insurance. We would like to express our gratitude for the recent decision to extend an additional two-month guaranteed issue period from the date of [...]

DPC Thanks California for Reinstating Nutritional Supplement Coverage

2024-03-29T02:08:07+00:00January 8th, 2014|Categories: Comment Letter, Medicaid, State Advocacy|

Ms. Pilar Williams, Chief Medical Supplies & Enteral Nutrition Benefits Branch, Pharmacy Benefits Division California Department of Health Care Services P. O. Box 997413, MS 4604 Sacramento, CA 95899-7413 Re: Proposed Policy Changes to Medi-Cal Enternal Nutrition Products Benefit Dear Ms. Williams, On behalf of the more than 50,000 people on dialysis in California, Dialysis Patient Citizens (DPC) would like to thank you and the state of California for restoring Medi-Cal coverage of enteral nutritional supplements for dialysis patients. With 30,000 members nationwide, DPC works to improve the quality of life of all kidney patients. Access to medically necessary oral [...]

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