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Number of dialysis patients statewide: 5,519 2012 Legislative Session: January 9 – March 8 |
Medicare, a federal program, pays for dialysis for over 80% of dialysis treatments. However, many issues concerning dialysis patients are actually handled at the state level.
Individual states have to provide certain basic services under Medicaid, but they also have flexibility in how they structure their plans and set their reimbursement rates. In addition, some states have the authority to determine the need and location for additional dialysis facilities (this is often referred to as certificate of need). Because dialysis patients’ care can be affected by state officials as well as federal officials, DPC members are becoming more active on state issues—ensuring the patients’ voice is heard locally as well as nationally.
2011 Medicaid Cuts
Effective January 1, 2011 Washington State Medicaid will no longer cover some health services for adults. Of particular concern to most dialysis patients is the elimination in podiatry care except to treat acute conditions, dental coverage except in emergency situations and the funding of Medicare Part D will end for beneficiaries who are dually eligible for Medicare and Medicaid. However, Medicaid beneficiaries are already eligible for Low Income Subsidy through Social Security. This subsidy will cover the cost of Medicare Part D premiums and deductibles. Medicaid beneficiaries will be responsible for the prescription co-pay cost, which is $2.50 for generics and $6.30 for brand name drugs. See the full list of cuts that go into effect this year.
>Read DPC’s comment letter to the State calling to attention the vital needs of coinsurance dialysis patients to have their prescription drug copayments covered by Washington.
Medicaid
In 2010 Washington State's Medicaid Program eliminated its previous coverage of oral nutritional supplements for adults, including those taken by dialysis patients on Medicaid. Oral nutritional supplements provide dialysis patients with many of the needed nutrients they need to remain healthy while on dialysis. Because many dialysis patients are on disability or have limited incomes, they often are not able to comply with their renal diet.
According to the United States Renal Data Systems, 76% of dialysis patients do not eat sufficient amounts of protein and 86% do not meet daily energy intake levels. Removing the Medicaid coverage of oral nutritional supplements would make it more difficult for patients to meet proper nutritional needs. Studies have shown that even a small increase in albumin can reduce hospitalizations by up to 41%. An increase in hospitalizations could result if access to supplements for dialysis patients was reduced, costing the state additional resources.
Despite our efforts to prevent the elimination of this coverage the program has been discontinued. However, we will work with the state to try to obtained renewed funding for oral nutritional supplements next year. In the meantime if you have been impacted by the elimination of this coverage please let us know. The more people who share their experiences with us the stronger our case will be in the future. Email DPC.
Washington Dialysis Patient Resources
#16 Northwest Renal Network
4702 42nd Avenue SW
Seattle, WA 98116
1-800-262-1514
Washington State Health Care Assistance
1-800-562-3022
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Adult Programs: Pays for medical care for those who can't afford it.