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DPC Urges Department of Insurance to Protect Dialysis Patient Access in Oregon

2024-03-29T01:50:31+00:00October 26th, 2015|Categories: Comment Letter, Private Insurance Coverage, Promote Financial Security, State Advocacy|Tags: |

Ms. Laura Cali, Insurance Commissioner Department of Consumer & Business Services Insurance Division PO Box 14480 Salem, Oregon 97309-0405 Re: Discrimination against end-stage renal disease patients by Regence health plan Dear Commissioner Cali: With 28,000 dialysis patient members, Dialysis Patient Citizens (DPC) is the nation’s largest patient-led organization representing individuals with end-stage renal disease (ESRD). I am writing on behalf of Oregon’s 3,821 dialysis patients, asking that you ensure that they are treated equitably by the Regence health insurance plan. Regulatory filings by this issuer indicate that its 2016 plan designs are incentivizing disenrollment of ESRD patients in favor of enrolling [...]

DPC Calls on Regulators to Investigate Insurer’s Renal Care Coverage Limitations

2024-03-29T01:50:31+00:00October 9th, 2015|Categories: Article, Promote Financial Security, State Advocacy|Tags: |

Kidney advocates are reacting to an alarming trend in the commercial insurance industry: insurers are increasingly writing language into policy documents that attempt to exclude or limit coverage of renal care. DPC is alerting regulators at both the state and federal levels to the harm these limitations could have on patients and asking them to enforce the numerous laws that prohibit health plans from discriminating against people with ESRD. Federal law guarantees that ESRD patients may keep their private insurance coverage for up to 30 months before enrolling in Medicare. The law also requires that health plans cannot differentiate between [...]

DPC, Kidney Patient, Testify at Hearing on Surprise Medical Bills

2024-03-29T01:50:31+00:00October 9th, 2015|Categories: Article, Legal Defense, Promote Financial Security, State Advocacy|Tags: |

DPC Policy Director Jackson Williams and Pittsburgh kidney patient Janice Nathan were among witnesses at a hearing held by Pennsylvania’s insurance commissioner on “surprise medical bills.” These are bills received from physicians who are outside of an insurer’s provider network even though they work inside facilities that are in-network. Janice Nathan’s primary care doctor recommended that she receive a cardiac stress test. Ms. Nathan checked her insurer’s provider directory and found an in-network facility to get the test. But when she received a cardiologist’s bill for $325—much more than the $50 co-pay she expected—she learned that the cardiologist who read [...]

DPC Assists Grassroots Efforts to Secure Level Medicaid Funding in Alabama

2024-03-29T01:50:31+00:00September 30th, 2015|Categories: Article, Medicaid, State Advocacy|

DPC has been hard at work on the state level fighting to ensure continued access to quality patient care, most recently in Alabama and North Carolina. In Alabama, patients fought to maintain Medicaid funding for outpatient dialysis, which the state was considering moving to local hospitals instead, in a potential effort to close the state budget shortfall. Patient advocates quickly took action and contacted their state legislators to encourage alternative revenue generating measures to close the budget gap as opposed to eliminating Medicaid funding. Thankfully, the state legislature responded by passing a budget with new revenue generating policies. The potential [...]

Joint Letter to Committees on Part B Premiums and Deductibles

2024-06-07T15:28:47+00:00September 30th, 2015|Categories: Medicaid, Medigap Coverage|

Dear Chairman Hatch, Senator Wyden, Chairman Ryan, Congressman Levin, Chairman Upton & Congressman Pallone: The undersigned organizations share a commitment to advancing the health and economic security of older adults, people with disabilities, and their families. We are writing to urge you to advance a solution to mitigate projected increases to Medicare Part B premiums and the Part B deductible in 2016. According to the 2015 Medicare Trustees Report, Part B premiums will increase by 52%—up to $159.30 per month from $104.90—for 30% of beneficiaries. The trustees also predict that this increase will be accompanied by a hike in the [...]

Re: Essential Health Benefits – 2017 Benchmark Plans

2024-03-29T01:50:32+00:00September 28th, 2015|Categories: Care Coordination, Comment Letter, Promote Financial Security|Tags: |

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

2024-03-29T01:50:32+00:00September 16th, 2015|Categories: Article, Charitable Premium Assistance, Comment Letter, Improve Access to Care, Promote Financial Security, State Advocacy|Tags: |

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

2024-03-29T01:50:32+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

2024-03-29T01:50:32+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 [...]

Congress Adopts Key Element of Kidney Community Agenda: Clinics May Soon Dialyze Acute Kidney Injury Patients

2024-03-29T01:50:32+00:00July 16th, 2015|Categories: Article, Medigap Coverage|

In passing the President's trade legislation last month, Congress enacted a longtime priority of kidney care advocates: permitting patients with acute kidney injury (AKI) to be treated in dialysis clinics. Under current law, AKI patients may only receive dialysis at hospitals, which is more costly to the Medicare program and less convenient for patients. Congress took this measure from the Chronic Kidney Disease Improvement in Research and Treatment Act, the comprehensive kidney bill that DPC has supported, so that the Medicare savings could pay for assistance to displaced workers. While DPC does not endorse the use of Medicare savings to offset [...]

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