Dialysis Patient Citizens News
Kidney Community Rallies for Key Victory in Louisiana
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 [...]
Medicare Ambulance Fraud in Los Angeles – A Specific Example
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 [...]
Medicare Announces Revised ESRD Seamless Care Organization (ESCO) Program
The ESCO is based on the Accountable Care Organization model, under which providers band together to improve care and share in any savings that result from avoiding costly complications. In the case of the ESCO, the care coordination teams would consist of dialysis providers, nephrologists and any new personnel, such as nurse case managers or health coaches, brought on to assist patients. An earlier version of the ESCO, announced last year, failed to garner sufficient interest among providers. In response to input from providers and patient advocates including [...]
The Senior Medicare Patrol Program Helps Medicare Beneficiaries Prevent, Detect, and Report Health Care Fraud
By Ginny Paulson, SMP Resource Center Director Medicare loses billions each year due to fraud, error, and abuse. This not only compromises the Medicare Trust Fund, but individual beneficiaries’ future benefits and health are placed at risk as well. This problem is being addressed at many levels of government, including the nationwide Senior Medicare Patrol (SMP) program. SMPs work at the grass roots level in all 50 states plus Washington D.C., Guam, Puerto Rico, and the U.S. Virgin Islands. The SMP mission is to empower and assist Medicare [...]
Re: Support for S.B. 403
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 [...]
Re: Discrimination Against Dialysis Patients by BlueCross Blue Shield of Louisiana
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 [...]
Dialysis Reimbursements Stabilized by Protecting Access to Medicare Act
This week President Obama signed the Protecting Access to Medicare Act, which contained some provisions favorable to dialysis patients. The primary purpose of the legislation was to stabilize Medicare payments to physicians, but Congress also used the opportunity to stabilize reimbursements to dialysis facilities. A large cut that had been scheduled to take effect in 2016 has been replaced by smaller, fixed-amount cuts that afford providers more certainty about revenues in coming years. This new payment formula will encourage providers to renew expiring leases on dialysis facilities and [...]
DPC Advocates Fly to Washington for 2014 World Kidney Fly-in
DPC advocates flew to Washington, DC for our 2014 World Kidney Day Fly-in. Twenty-six patients and family members were joined by 19 provider representatives from 24 states. Advocates conducted 94 meetings with Members of Congress and their staff. This year, we asked Congress to protect funding for the Medicare ESRD program and to open Medicare Part C to people on dialysis. Take a look at these pictures for the full story. The patients in the these pictures are our most active Patient Ambassadors. If you are interested in [...]
2014 World Kidney Day Fly-In
Dialysis Patient Citizens (DPC) will be hosting our annual World Kidney Day Fly-In from March 11 to March 13, 2014. Twenty-eight patients and family members from 23 states will arrive in Washington, DC to speak to nearly 100 Congressional offices about issues that affect people with kidney failure. In addition, the group will be joined by 17 dialysis facility professionals who will help amplify their message. The day prior to visiting Capitol Hill, participants will receive a comprehensive issue briefing and advocacy training from DPC staff. During this [...]
DPC Urges Administration to Keep Dialysis Accessible in Obamacare Health Plans
DPC recently urged the Department of Health and Human Services (HHS) to ensure that provider networks in new Affordable Care Act health plans offer convenient access to dialysis facilities. DPC told HHS that “since dialysis patients must typically undergo treatment three times per week, travel to and from a dialysis facility is far more burdensome than travel to physician offices or other sites of care that are visited less frequently. If a health plan limits its network to a single dialysis organization—as we fear some may do, [...]
DPC Urges Medicare Agency to Withdraw Proposal That Could Weaken Protections for Transplant Patients
Dialysis Patient Citizens (DPC) weighed in against a Medicare proposal that would complicate some transplant patients’ access to immunosuppressive drugs. Medicare Part D, like other private health plans, uses drug formularies to keep down costs. Formularies favor certain drugs over others in exchange for discounts. Patients are encouraged to ask their doctors to first prescribe medications on the formulary to take advantage of lower co-pays. Often a patient’s condition can be addressed by a drug on the formulary, but many transplant patients find that “first-line” immunosuppressive treatments [...]
3 Things You Can Do for National Kidney Month
March is National Kidney Month which provides the perfect opportunity to educate your community about kidney disease! Here are some suggestions to help you increase awareness about kidney disease: The DPC Education Center is holding a grassroots fundraiser to raise money for our kidney education efforts. We'll give you the tools you will need to participate. Fundraise World Kidney Day is March 13. If you are interested in handing out information in your dialysis facility or your community, we can provide all the materials and instructions [...]
We Need to Hear From You!
DPC is currently working on two initiatives that require your input! First, the National Quality Forum is conducting a study of "Person-Centered Care" and is looking for patient input. DPC has volunteered to collect patient viewpoints on this subject, and we are inviting our members and other dialysis patients to share your experience with and insights into the care you've received. The National Quality Forum is an organization that endorses the standardized healthcare performance measures that are used by Medicare and other insurers to monitor quality. Its goal in this project [...]
DPC Thanks Texas for Allowing ESRD Patients to Purchase Medigap Plans
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 [...]
For New Kidney Failure Patients Under 65: Is Medicare or an Exchange Plan the Better Insurance Option?
Chronic Kidney Disease (CKD) patients who progress to end-stage renal disease (ESRD) before the age of 65 now have a new health insurance option—exchange health plans under the Affordable Care Act (ACA). Non-elderly patients who do not have, or will not be continuing, employer-sponsored insurance may be better off in an exchange plan depending on their financial circumstances. The reason for this is that the Affordable Care Act is more generous than Medicare in providing extra financial assistance to low-income individuals. Medicare Programs for Low-Income Patients Patient advocates [...]
DPC Thanks California for Reinstating Nutritional Supplement Coverage
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 [...]
DPC Encourages Coverage of Renal Dialysis in Exchange Plans
Hon. Marilyn Tavenner, Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Ave, SW Washington, D.C. 20201 Re: Coverage of Renal Dialysis in Exchange Plans Dear Administrator Tavenner: Dialysis Patient Citizens, America’s largest patient-led organization representing dialysis patients, is comprised of more than 26,000 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 express our concerns about language we found in [...]