Dialysis Patient Citizens News
DPC Submits Comments on Market Stabilization
A recent proposed rule released by the Centers for Medicare & Medicaid Services (CMS) provided guidance for market stabilization of the Affordable Care Act. Within this proposed rule, network adequacy provisions for dialysis clinics provided a narrow scope for insurers. In comments submitted by DPC on March 6, we argued stronger time and distance criteria need to be added to these provisions. Research shows there is little difference between living in a metropolitan area compared to living in a rural environment, but there are significant mortality risks associated [...]
Advocating for Patients on World Kidney Day
Today the global community of people fighting kidney disease commemorates World Kidney Day, an effort to raise awareness of the importance of healthy kidneys and reduce the devastating impact of kidney disease, which affects 1 out of every 10 people worldwide. Although the condition is incurable, effective treatments are available. An estimated 2.6 million people with end-stage renal disease (ESRD), or kidney failure, received dialysis in 2010. That number is expected to more than double to 5.4 million by 2030. As the incidence of kidney disease rises, so [...]
Dialysis Patient Citizens Wins Court Ruling Against Insurer Veto on ESRD Patients
In a lawsuit filed by DPC against the Department of Health and Human Services, a federal court has blocked a regulation that would have given insurers veto power over ESRD patients’ access to private coverage. The judge called the regulation, that could have forced dialysis patients off their current health insurance and jeopardized their access to care, “arbitrary and capricious.” In enjoining the regulation’s enforcement, the U.S. District Court for the Eastern District of Texas held that the rule was 1) procedurally defective because HHS adopted it [...]
Dialysis Patient Advocates Applaud Ruling in Case Against CMS
Federal court blocks CMS regulation that would give insurers veto power over access to private coverage; judge calls it ‘arbitrary and capricious’ Washington, D.C. – Advocates for dialysis patients are celebrating a federal court ruling today to grant a preliminary injunction preventing the U.S. Department of Health and Human Services (HHS) from implementing a regulation that could force patients off their current health insurance and jeopardize their access to care. In enjoining the regulation’s enforcement, the U.S. District Court for the Eastern District of Texas held that [...]
Re: CMS-3337-IFC: Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities—Third Party Payment
Re: CMS-3337-IFC: Medicare Program; Conditions for Coverage for End-Stage Renal Disease Facilities--Third Party Payment To whom it may concern: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced interim final rule. We are requesting that the Agency withdraw the rule and follow the notice-and-comment rulemaking process prescribed by the Administrative Procedures Act (APA). We explain below why this unusual regulatory action reached an incorrect result. DPC's membership is restricted to kidney disease patients and their family members. We have more than 28,000 total [...]
Dialysis Patient Advocates Seek Restraining Order Against CMS
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 [...]
Protecting Dialysis Patients’ Health Coverage
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 [...]
Dialysis Patients Outraged by CMS Move Giving Insurers Illegal Veto Power Over Access to Private Coverage
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 [...]
CMS Updates Policies and Payment Rates for End-Stage Renal Disease Prospective Payment System (CMS 1651-F)
On October 28, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished beginning January 1, 2017. Under the ESRD PPS for 2017, Medicare expects to pay approximately $9 billion to approximately 6,000 ESRD facilities to cover dialysis services. The finalized 2017 ESRD base rate will be $231.55. CMS projects that the updates for 2017 will increase total payments to all ESRD facilities by 0.73 percent compared [...]
CMS Announces Changes to Dialysis Facility Compare and Star Ratings
On October 28, 2016, the Centers for Medicare & Medicaid Services (CMS) added patient experience survey results and two new clinical quality measures as well as updated the way CMS calculates star ratings on its Dialysis Facility Compare website. The star ratings were originally included on the Dialysis Facility Compare website on January 22, 2015 and were previously updated in October 2015. Currently, there are star ratings on Dialysis Facility Compare, Nursing Home Compare, Physician Compare, Home Health Compare and Hospital Compare. CMS is adding patient experience of [...]
Urge the U.S. Senate to Open Medicare Advantage for ESRD Patients
The ESRD Choice Act (H.R. 5659) unanimously passed in the House of Representatives on September 21. Thanks in large part to your persistent advocacy, we are now one step closer to opening Medicare Advantage enrollment to ESRD patients. Unfortunately, we still need the Senate to take action. Please take a few minutes to urge your Senators to move this issue to the President’s desk for signature. Contact your Senators about the importance of expanding insurance options for ESRD patients. Learn more about Medicare Advantage
DPC Submits Comments to CMS’ Request for Information
In late August, the Centers for Medicare and Medicaid Services (CMS) placed a Request for Information about insurance steering and the use of third-party payments for insurance premiums. DPC has consistently advocated for patient choice in regards to insurance plans, we believe patients have the right to choose an insurance plan that works best with their health needs and desired outcomes. DPC submitted comments in response to this request emphasizing the increased benefits some exchange plans offer to dialysis patients as opposed to traditional Medicare. In addition to submitting formal [...]