Veteran's Administration Proposed Payment Reduction

Recently, the Veteran’s Administration (VA) has proposed reducing reimbursement payments for all non-VA inpatient and outpatient care which would include payments for dialysis treatment. The proposed reimbursement would fund treatment at the same rate as Medicare; however, the current Medicare reimbursement rate does not fully cover the cost of each treatment.  Because the proposed reimbursement rate would be lower than the actual costs of treatment, if enacted, this policy could cause problems for veteran patients and dialysis facilities.

DPC is concerned about how this proposal could affect dialysis patients.  If facilities had a high number of veteran patients, the facility may not be able to sustain operations with the reduced rates, or they may not be able to accept new VA patients.   Additionally, to receive treatments VA patients may have no choice but to enter the Medicare program resulting in new premiums, deductibles, and co pays.

Before the comment period closed, DPC submitted comments to the Department of Veteran’s Affairs regarding this issue.   In addition, veterans who are affected by this proposal are encouraged to contact your Members of Congress to let them know how this proposed rule could negatively affect your access to dialysis treatment.  A final rule is expected in the coming months, and once the final ruling is released, DPC will provide the relevant information to our membership.

Medicare PPS Update

As you are aware, The Centers for Medicare and Medicaid Services (CMS) has been instructed by Congress to create a “bundled” payment for dialysis services.  This single payment includes treatment, lab, and certain medication costs. 

However, DPC and others still have concerns with the proposed rule as written.  DPC and our members have sent letters to CMS, contacted Members of Congress, and met with Congressional staff during World Kidney Day to express patients concerns with the current proposed bundle.  Recently, representatives from DPC, National Kidney Foundation (NKF), American Kidney Fund (AKF), and Renal Support Network (RSN) met with CMS to discuss patient concerns with the bundle.  These concerns include the inclusion of oral medications without an IV equivalent in the bundle, lack of adequate home dialysis training, the lack of a race adjustor, patient responsibility for laboratory fees and the transition payment.  The patient community was well received; however, CMS could not provide comment on the issue due to the fact they are still in active rulemaking.

All indications are that CMS will release the next version of the bundle in May or June.  Following the release of the next version of the rule, DPC will work to summarize the rule for our membership and advocate, as needed, on provisions.  Please visit www.dialysispatients.org for more information.

Medigap Coverage Advances in Tennessee and Georgia

DPC, along with many members of the kidney care community, have been working to increase the number of states that allow Medicare ESRD beneficiaries, regardless of age, to purchase Medigap supplemental insurance coverage.  Without the supplemental coverage, beneficiaries can be required to cover co-payments and co-insurance out of pocket or possibly spend down their assets until they are eligible for state Medicaid.

Thanks to the work of the community and DPC’s dedicated members, we are close to seeing the 30th and 31st states pass Medigap legislation.  Last week, Georgia’s House of Representatives joined the Senate in passing Medigap coverage for all Medicare beneficiaries.  Following the Governor’s signature, the bill will become law.  Recently in Tennessee, the House Finance Budget Subcommittee held a hearing and passed legislation that would allow all Medicare beneficiaries to purchase Medigap coverage.  The bill has already passed the Tennessee Senate and is close to full passage.

DPC wants to give a special thank you to all the DPC members in Georgia and Tennessee who have rallied around these bills and have helped the bill advance.  Our work is not finished yet.   DPC is working with community leaders to identify the next targets for Medigap outreach.  Stay tuned.

DPC Launches New Partners in Care Program for Kidney Care Professionals

DPC Partners in Care is a new program designed to unite kidney care professionals with patients in initiatives to promote patient empowerment and improved quality of life for all dialysis patients.

The program – open to physicians, nurses, social workers, dieticians, dialysis facility administrators and others – strives to increase communication between kidney caregivers and patients on matters that can improve patients’ quality of care and quality of life.  Partners in Care will work toward these goals through the delivery of updates on key public policy issues in kidney care; providing caregivers a greater understanding of the patient community’s perspective on these issues; and supporting patients in their advocacy efforts by uniting patients and care providers in grassroots activities. 

In addition, Partners in Care will have a strong focus on patient education by facilitating ways for clinicians to better engage patients to take an active role in their own care and to help educate fellow patients on the importance of being an involved member of their care team.  By strengthening the caregiver-patient partnership, Partners in Care aims to help patients get more involved in their own care, leading to improved awareness, care outcomes and quality of life.

Joining the program is free, and in addition to receiving regular up-to-date information on matters that may help improve patients’ kidney care nationally and at the state level, Partners in Care members will receive fact sheets, brochures, outreach tools and additional information for discussing quality-of-care issues and care empowerment with their patients.  Learn more about becoming a Partner in Care.