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Legislation Offers Hope for Kidney Patients Struggling with Coverage

2024-03-29T01:09:23+00:00July 21st, 2022|Categories: Medigap Coverage, Patient Stories in the News, Spotlight|

Kidney disease is a life-changing diagnosis for patients and their families. I experienced it first-hand as my husband went through dialysis and a kidney transplant, and I continue to see it every day working with kidney patients who are facing issues with treatments and cost. One of the most heartbreaking realities I see working with patients is that many are held back because they can’t get affordable coverage for the treatments they need to stay alive, since Medicare only covers part of the cost. That’s why we need Congress to pass the Jack Reynolds Memorial Medigap Expansion Act. The bill [...]

Dialysis Patients

2024-03-29T01:09:23+00:00July 19th, 2022|Categories: Medigap Coverage, Patient Stories in the News|

Life with kidney disease while I was working in the United Arab Emirates was very different compared to what it is in the U.S. I had to receive all of my treatments in the hospital, and because the coverage options available weren’t the same as they are here, I had to pay for my treatments out of pocket. I felt I could get better options moving back to the U.S., but it was still remarkably expensive. Because Medicare only covers 80% of the cost of treatment, I needed to buy additional coverage to help pay for the rest until I [...]

Letter to the editor: Much-needed relief for dialysis patients

2024-03-29T01:09:23+00:00July 13th, 2022|Categories: Medigap Coverage, Patient Stories in the News|

How much money do you make in an average year? Think about it for a minute. Now, imagine that entire annual salary, and then some, is gone in a month. Why, you may ask? Because those are the costs dialysis patients incur on a monthly basis. While all dialysis patients are covered by traditional Medicare, this only covers 80 percent, leaving patients to try to find a way to pay for the rest. One point four million dollars. That is the amount billed to my secondary insurance, which I am fortunate to get through my wife's work, since July 1, [...]

Congress needs understanding

2024-03-29T01:10:06+00:00July 8th, 2022|Categories: Medigap Coverage, Patient Stories in the News|

I was devastated when I wound up in the emergency room and found out my kidneys had failed. I was immediately placed on dialysis and began a new way of life. My new reality meant spending many hours per week at my dialysis center receiving life-saving treatments. Dialysis treatments can be costly. Medicare will only cover up to 80% of the costs, and my options are limited for covering the rest since I’m under 65. I am lucky to have had assistance from the American Kidney Fund to help pay the remainder. However, many patients are not as fortunate and [...]

Medicare Dental Coverage for Transplant Candidates May be on the Way

2024-03-29T01:10:06+00:00July 5th, 2022|Categories: Article, Dental Coverage, Medicare Advantage|

The Centers for Medicare & Medicaid Services (CMS) is proposing expanded coverage of “medically necessary” dental treatment, including treatments necessary to qualify for an organ transplant. DPC and other consumer advocates have been pressing for this change for several years. Medicare currently pays for dental services in a limited number of circumstances, such as when that service is an integral part of specific treatment of a beneficiary’s primary medical condition. Some examples include reconstruction of the jaw following accidental injury, tooth extractions done in preparations for radiation treatment for cancer involving the jaw, or oral exams preceding kidney transplantation. CMS is [...]

Medicare Proposes Small Pay Increase for Dialysis Facilities

2024-03-29T01:10:06+00:00July 1st, 2022|Categories: Article, Dialysis Funding, Medicare Advantage|

On June 21, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update payment rates and policies under the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries for the year beginning January 1, 2023. Under the ESRD PPS for 2023, Medicare expects to pay $8.2 billion to approximately 7,800 ESRD facilities for furnishing dialysis services. The proposed 2023 ESRD PPS base rate is $264.09, which would be an increase of $6.19 to the current base rate of $257.90. CMS projects that the updates for CY 2023 would [...]

LETTER: Making a difference for kidney patients

2024-03-29T01:10:07+00:00July 1st, 2022|Categories: Medigap Coverage, Patient Stories in the News, Spotlight|

DEAR EDITOR: I recently participated in my second advocacy day meetings as part of Dialysis Patient Citizens, and am still overjoyed with the discussions I had with several of our distinguished members of Congress and their staff. I spoke briefly about how my own experience as a dialysis patient took away so much of my independence, and what so many patients have to deal with daily just to stay healthy, on top of appointments and unforeseen hospitalizations. These can seriously affect patients, especially when dealing with hospital bills that can turn into massive debts. For many dialysis patients, Medicare is [...]

Rhode Island Passes Medigap Access Legislation

2024-03-29T01:10:07+00:00June 24th, 2022|Categories: Article, Improve Access to Care, Medigap Coverage|

On Thursday, June 23, 2022, the Rhode Island General Assembly held the final vote leading to passage of two bills granting access to Medigap coverage for dialysis patients under age 65. Sponsored by Rep. Brian Patrick Kennedy (D-District 38), Speaker Pro Tempore, and Senator Dennis L. Algiere (R-District 38), Senate Minority Leader, H 7244 and S 2194 require that Medicare supplement policies be made available to any applicant under age 65 eligible for Medicare due to a disability or End Stage Renal Disease (ESRD). The legislative language in these bills (which is identical) specifies that Medicare Supplement Plan A be made [...]

Supreme Court Erases Kidney Patients’ Insurance Protections

2024-03-29T01:10:07+00:00June 22nd, 2022|Categories: Article, Dialysis Funding, Medicare Advantage, Private Insurance Coverage, Protect Patient Care|

A U.S. Supreme Court ruling has nullified the law that protects dialysis patients from discrimination by insurers, threatening the system of financing kidney care that has stood for 40 years. The Court ruled that employer health plans may limit dialysis benefits. For four decades, employers understood the law as prohibiting limitations that only applied to dialysis. Some health benefit consultants encouraged a few small employers to disregard the law by paying no more than Medicare rates for dialysis. DaVita sued them, and one of the cases was appealed to the Supreme Court. The decision means that employers and insurers can [...]

Dialysis Patient Citizens Statement Following Supreme Court Decision in Marietta Memorial Hospital v. Davita

2024-03-29T01:10:07+00:00June 21st, 2022|Categories: Medicare Advantage, Press Release, Private Insurance Coverage, Protect Patient Care|

WASHINGTON, D.C., (June 21, 2022) -- Following the United States Supreme Court decision in the case of Marietta Memorial Hospital v. Davita, Dialysis Patient Citizens (DPC) Board of Directors President Andrew Conkling issued the following statement: “DPC is deeply disappointed by today’s Supreme Court decision,” said DPC Board President Andrew Conkling. “Congress long ago reaffirmed privately-insured patients’ right to continue on their employer-sponsored plan for 30 months. This played an important role in preserving patient choice and incentivizing insurers to detect and treat Chronic Kidney Disease. ESRD patients are among the most vulnerable Americans and face some of the largest [...]

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