Dialysis Patient Citizens News
Rhode Island Medigap Legislation Signed by Governor McKee
On June 30,2022, Rhode Island Governor Dan McKee signed into law H. 7244 and S. 2194, which provide guaranteed issue access to Medicare Supplement Insurance coverage – known as Medigap – for under age 65 residents with End Stage Renal Disease (ESRD) and qualified disabled. The legislation becomes effective July 1, 2023. The new law also provides premium protections through the premium rate review process of the Office of the State Health Insurance Commissioner. While DPC is disappointed that this legislation limits access only to Medicare Supplement Plan [...]
Legislation Offers Hope for Kidney Patients Struggling with Coverage
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 [...]
Dialysis Patients
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 [...]
Letter to the editor: Much-needed relief for dialysis patients
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, [...]
Congress needs understanding
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 [...]
Medicare Dental Coverage for Transplant Candidates May be on the Way
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 [...]
Medicare Proposes Small Pay Increase for Dialysis Facilities
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 [...]
LETTER: Making a difference for kidney patients
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 [...]
Rhode Island Passes Medigap Access Legislation
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 [...]
Supreme Court Erases Kidney Patients’ Insurance Protections
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 [...]
Dialysis Patient Citizens Statement Following Supreme Court Decision in Marietta Memorial Hospital v. Davita
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 [...]
Aid dialysis patients
Families have a lot in common, and something mine shares is kidney disease. Both my late mother and I who have suffered from this have had to receive life-saving dialysis treatments that allowed our bodies to continue to function. At the beginning of my dialysis journey, I had insurance through my employer, which covered the costs of these pricey treatments. However, they took up most of my time and energy, and I inevitably had to leave my job. Being unable to work full-time is a persistent problem [...]
Letter: Medigap bill offers lifeline to young dialysis patients
Dear Editor: Starting dialysis at a young age was hard. I had only recently finished high school, and adjusting to life on dialysis when I was still a teenager was overwhelming. It was even more difficult because I didn’t have reliable access to affordable Medigap coverage for the costs Medicare didn’t pay. Not every state requires Medigap plans to be available to patients under 65, so unless you qualify for disability or another form of coverage, patients are on the hook for what Medicare doesn’t cover. Even [...]
Your Views: Wisconsin kidney patients need financial help
My life with kidney disease has been one filled with battles. In 2010, I had a double transplant surgery and received a new kidney and liver. Unfortunately, the transplant kidney failed three years ago, and I needed dialysis treatment. These life-saving treatments can be time-consuming, and patients often find themselves unable to work. Working and being on dialysis can be very hard on someone. I’m lucky that I have Medicare covering the majority of the costs and additional insurance paying for what Medicare didn’t before I turned [...]
Letter: Congress should follow NY’s lead on dialysis coverage
Finding out my kidneys were failing was shocking. During a surgery to remove a portion of one kidney affected by cancer, things took an unexpected turn. Rather than losing a small portion of function in one kidney, I was left with one kidney only functioning at 20 percent. Thanks to an excellent nephrologist, though, I was able to put off starting dialysis for a decade. Since then, two things that have helped a great deal are the flexibility of my home treatments and the access I’ve had [...]
Kidney Patients Struggling to Receive Coverage
My husband’s journey with kidney disease forever changed my life. Over the past five years, we have seen countless doctors, traveled many miles for medical appointments, and both of us had lifechanging surgeries. At age 39, my husband began dialysis treatments for his failing kidneys, a side effect of his lifelong battle with diabetes. We knew he would eventually need a kidney transplant but needed to get other health matters in order before that would be possible. Finally, my husband was ready for a kidney transplant, and [...]
Congress should OK Medigap expansion
I have fought an uphill battle with kidney disease for almost half my life. At 24, I started receiving dialysis treatment and three years later received a kidney transplant that kept me off dialysis for about five years. But unfortunately, I needed potent anti-rejection drugs that ultimately gave me cancer and weakened my immune system. Thankfully, I recovered from cancer but ended up back on dialysis, which I still receive. Part of the problem stems from the fact that my treatments haven't always been tailored to what [...]
Constituents on Dialysis Need Leader McCarthy’s Help
Editor, Being diagnosed with kidney disease when I was just 16 turned my life on its head overnight. Kidney failure can cause multiple medical complications. Partial loss of my vision and hearing, more than 17 years of dialysis treatments, infections, an enlarged heart, and eventually a kidney transplant have been just part of the journey. For all of these challenges, though, one hurdle I thankfully didn’t have to face was access to coverage. Since I was so young when I started treatment, my parents’ insurance helped pay [...]
What Patients Should Know About Value-Based Care
DPC is a strong advocate of Value-Based Care. Value-Based Care means that your primary providers accept a single payment or budgeted amount to cover all your medical needs. For instance, if you are in a program like Comprehensive Kidney Care Contracting (or CKCC, formerly known as the ESCO program) your dialysis provider and nephrologist take responsibility for all your care—not just kidney care but other conditions, such as diabetes, and other sites of care, such as hospitals. There are currently three types of value-based care programs that [...]
DPC Hosts Successful 2022 Congressional Advocacy Day
On Thursday, May 12th, DPC hosted its’ annual Advocacy Day when we connect patients, family members, and Partners in Care with their Members of Congress so they can tell their story with dialysis and advocate for legislative priorities that would help them. Once again, out of an abundance of caution, our advocacy day was virtual, but we were still able to have wonderful participation. This year we had 113 participants who participated in 113 meetings and represented 29 states. They talked with their Congressional offices about The Jack [...]