Dialysis Patient Citizens News
A Strong Voice for Dialysis Patients
With the gridlock in Congress reaching new heights, it is more important now than ever for dialysis patients to have a strong voice in policymaking. DPC is well-equipped to serve as that voice since it is a patient-led organization (the Board of Directors consists entirely of patients). Joining DPC means you are serious about improving the quality of care for dialysis patients, and sends a signal to legislators that this will be on the top of your mind when you go to the ballot box in November. They [...]
DPC’s Request for Correction complaint to CMS Regarding DFC Star Ratings
Attached is CCSQ’s courtesy copy of the Request for Correction we filed today under the Data Quality Act challenging the methodology to be used in the DFC Star Ratings. The Data Quality Act and the HHS Information Quality Guidelines promulgated pursuant to the Act have been in existence for approximately as long as CMS has collected and reported quality measures. Over the past decade, no stakeholder has ever filed a Request for Correction with CMS pertaining to quality measurements. We take no joy in being the first, but [...]
Insights with Jack: Reflections on Thanksgiving
By Jack Reynolds, DPC Board Member and Patient Ambassador My Grandma Mae lived to be 96 and she had a saying, “One has to learn how to suffer." I think what she really meant was that a person must learn how to handle or manage their suffering whether it be physical, mental, or emotional. Over time most ESRD patients are confronted with a host of these challenges or sufferings. Frankly, I have been spared many of the hospitalizations and complications that many dialysis patients experience. For example, I [...]
Prior Authorization of Non-Emergency Ambulance Transportation to Begin for Dialysis Patients in New Jersey, Pennsylvania and South Carolina
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 [...]
Election Results Shouldn’t Affect ESRD Program, But New Members of Congress Need to be Educated on Medicare’s Role
Republicans gained control of the U.S. Senate in last week's elections, but this change is not expected to affect Congressional policymaking on dialysis issues. While some health care issues involve contentious partisan bickering, historically the nuts-and-bolts, day-to-day operations of the Medicare program have been managed on a bipartisan basis by Congress' professional staff members, overseen by Congressional committee chairs with expertise on Medicare. What will be different is that many new Members of Congress will take office in January who do not have experience with Medicare or ESRD [...]
New Dialysis Quality Rules May Bring Small but Noticeable Changes to Your Care
The Centers for Medicare and Medicaid Services (CMS) recently finalized the payment rule for the Medicare End Stage Renal Disease (ESRD) program for 2015. Payment rates will stay the same next year. However, changes to the Quality Improvement Program (QIP) system of "pay for performance" are intended to prioritize new aspects of care for ESRD patients; providers are graded on each element of the "QIP" and receive payment reductions if they don't meet Medicare's standard. This means that providers are expected to add emphasis to these new areas [...]
Insights with Jack: Who Do You Rely On?
By Jack Reynolds, DPC Board Member and Patient Ambassador This Christmas of 2014, I will have completed four decades of in-center hemodialysis. As this amount of time surviving with a kidney machine as a life partner is fairly rare, I feel that it would be a good idea to discuss or maybe vent my soul about my experience as a dialysis citizen and how it has affected my outlook on life. I plan to keep my blogs fairly short and to only touch on one or two points [...]
CMS Responses to Questions and Comments about the Dialysis Facility Compare Star Rating System
CMS thanks the community for their comments and questions about the DFC Star Rating System. All comments have been given serious consideration. This document provides responses to the questions and issues raised by the ESRD community. CMS believes that the Star Rating System will empower consumers with additional quality information. It will also encourage providers to continuously achieve higher quality care. With future releases and enhancements to the DFC website, we will continue fostering an open dialogue to facilitate providing better care for all patients receiving chronic dialysis. [...]
Response Memo: FAQs Regarding Medicare and the Health Insurance Marketplace
To: James Canavan, Center for Medicare, Centers for Medicare & Medicaid Services Spencer Manasse, Center for Consumer Information and Insurance Oversight, CMS Vicki Gottlich, Administration for Community Living Gene Coffey, Center for Medicaid and CHIP Services, CMS Janet Miller, Office of Communications, CMS Sharon Donovan, Medicare-Medicaid Coordination Office, CMS Re: Comments on “Frequently Asked Questions Regarding Medicare and the Marketplace” We appreciate that the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) arranged a July meeting for beneficiary advocates to discuss [...]
Statement of Dialysis Patient Citizens on CMS Announcement of Delay in Implementing Star Ratings for Dialysis Facility Compare Website
Today, Dialysis Patient Citizens received a notice from CMS announcing a three-month delay in implementing its Star Ratings Program for the Dialysis Facility Compare website. Contrary to CMS’ announcement, a delay alone is not responsive to the concerns expressed by stakeholders and certainly not to those expressed by DPC. While CMS said it was “partnering with the ESRD community,” it has instead declined to consider input on how to design patient-friendly ratings, and ignored DPC’s requests to see consumer testing materials and the geographic distribution of star assignments. [...]
DPC Submits Comments on this Year’s Medicare ESRD Payment Rule
In late August, DPC submitted comments to the Center for Medicare and Medicaid Services (CMS) on its payment-setting rule for dialysis facilities in 2015. The rule keeps next year’s payments for dialysis level with this year’s, following a mandate from Congress, but makes some changes to the ESRD Quality Incentive Program (“QIP”) that reduces payments to the lowest-performing facilities. Here are highlights of proposed changes along with DPC’s commentary: Patient Satisfaction Survey Scores To Count Toward QIP Payment Reductions: For several years now, dialysis facilities have administered the [...]
DPC Mourns the Loss of Previous Board Members
DPC was saddened to learn of the recent passing of two of our previous board members, Robert (Bob) Mize and William (Bill) Litchfield. Robert Mize was one of three patients who served as a founding board member. He was instrumental in laying the groundwork for the successful advocacy and education programs we produce today. He frequently made trips to Washington, D.C. to elevate the patient voice and his dedication to promoting kidney disease awareness and education will surely be missed. Robert Mize on the steps of [...]
DPC to Host Regional Meetings
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 [...]
Medicare Agency Under Fire For “Star” Ratings of Health Care Providers
Can Dialysis Facilities Be Rated Like Movies and Restaurants? Earlier this year, the Center for Medicare and Medicaid Services (CMS) announced plans to expand its movie critic-style “star” rating system, currently in place for nursing homes and Medicare HMOs, to include dialysis facilities and other health care providers. The controversy began earlier this summer when CMS disclosed the system it had devised to assign star ratings for dialysis facilities. DPC was among the first to speak out and express concern, emphasizing four items in particular: Stars were to [...]
DPC Comments on 2015 Prospective Payment System and QIP
Hon. Marilyn Tavenner, Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, SW Washington, D.C. 20201 Re: CMS-1614-P: End-Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Dear Administrator Tavenner: Dialysis Patient Citizens (DPC) appreciates the opportunity to provide the Centers for Medicare and Medicaid Services (CMS) with comments on the proposed payment rule for the Medicare End Stage Renal Disease (ESRD) program. As America’s largest patient-led organization [...]
Kidney Patients Join Industry In Opposing CMS’ Dialysis Star Rating System
Kidney patients have joined the fight against the Medicare star-rating program for dialysis facilities, and they’re making the same arguments as industry. Patient advocates say that the bell curve nature of the program will confuse patients, especially those in poor areas; the program is inconsistent with the existing dialysis Quality Incentive Program; and CMS should have sought feedback from patients and providers before forcing the program on them
Dialysis Patient Citizens Critical of Dialysis Facility Compare’s Five-Star Rating System
In a letter to the Centers for Medicare & Medicaid Services’ Center for Clinical Standards and Quality, Dialysis Patient Citizens expressed concern about the implementation of Dialysis Facility Compare’s new five-star rating system.
New Medicare Rule for Dialysis Facilities Brings Changes to “Pay for Performance” Formula
Last week, the Centers for Medicare and Medicaid Services (CMS) released its Proposed Rule specifying how dialysis facilities will be paid in 2015 and beyond. Most of the proposed changes relate to the Quality Improvement Program for dialysis. The Quality Improvement Program (QIP) sets performance standards for each clinic and penalizes clinics that do not meet or make progress toward the standards by cutting their payments by up to two percent. The purpose is to incentivize providers to do a better job by tying their pay to [...]