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DPC Comments to CMS Sound Alarm on Workforce Shortages

2024-08-22T14:11:27+00:00August 20th, 2024|Categories: Article, Comment Letter, Innovation, Medicare Advantage, Promote Financial Security, Protect Patient Care|

In our comments responding to Medicare’s annual ESRD Payment Rule, DPC took the government to task over payment updates that lag increases in labor costs and failure to effectively cover new drugs for dialysis patients. The proposed rule grants a net increase in the base rate of only 0.8% during a year in which wages, according to Bureau of Labor Statistics, rose 4.2%. The Medicare Payment Advisory Commission estimates a margin of zero for dialysis facilities in 2024, with many rural and low-volume facilities in the red. This occurs at a time in which a Supreme Court decision has emboldened [...]

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DPC’s Letter to Hon. Chiquita Brooks-LaSure, Administrator for CMS, on CMS-1805-P

2024-08-19T16:23:37+00:00August 19th, 2024|Categories: Comment Letter, Improve Access to Care, Increase Quality of Care, Policy Issues, Promote Financial Security, Protect Patient Care|

August 19, 2024 Hon. Chiquita Brooks-LaSure, Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD  21244 Re: CMS-1805-P:  End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, Conditions for Coverage for End-Stage Renal Disease Facilities, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model Dear Administrator Brooks-LaSure: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced proposed rule. DPC's membership, currently about 35,000, is restricted to kidney disease patients and their family members. DPC is a patient-led organization.  Our by-laws require [...]

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DPC’s Letter to Hon. Jonathan Blum, Principal Deputy Administrator for CMS, on New Drugs in the ESRD PPS

2024-06-27T14:42:14+00:00June 11th, 2024|Categories: Advance Patient Choice, Comment Letter, Increase Quality of Care, Innovation, Protect Patient Care, Treatment Options|

June 11, 2024 The Honorable Jonathan Blum Principal Deputy Administrator Centers for Medicare & Medicaid Services 200 Independence Avenue, SW Washington, DC  20515 Re:  New drugs in the ESRD PPS Dear Principal Deputy Administrator Blum: In our comments on the 2024 ESRD payment rule, we expressed our concerns about how patients experienced the rollout of Korsuva, the drug that treats ESRD-related pruritis. We noted that the prescribing behavior of nephrologists has amounted to, in effect, a de facto embargo of the medication. Empirical research has found a prevalence of moderate to severe pruritis among dialysis patients of 33 percent, but [...]

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DPC Letter to CMMI on ESRD Treatment Choices Demonstration Issues

2024-03-29T01:09:16+00:00October 10th, 2023|Categories: Comment Letter, Improve Access to Care, Treatment Options|

October 10, 2023 Dr. Elizabeth Fowler, Deputy Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD  21244 Re: ESRD Treatment Choices Demonstration Issues Dear Dr. Fowler: Last year, published research looking at CMMI’s ESRD Treatment Choices Model (ETC) indicated that the program is not having the effect that was hypothesized. Now, CMMI’s own evaluation contractor has echoed those findings. We urge CMMI to pause and reassess whether ETC was the best available policy intervention to promote home dialysis and transplantation, and consider alternatives. ETC imposes a bonus-and-penalty payment adjustment in randomly selected intervention regions to incentivize kidney providers [...]

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DPC Raises Alarm on Health Workforce Shortages

2024-03-29T01:09:16+00:00August 23rd, 2023|Categories: Article, Comment Letter, Improve Access to Care, Medicare Advantage, Quality Incentive Program|

DPC’s letter commenting on this year’s ESRD Payment Rule warns that Medicare is not addressing workforce shortages that are impacting patient care. The letter reports the following findings from our recent member survey: 62% of patients reported that the recent labor shortages had impacted their care: 43% said that staff turnover disrupted their care; 28% reported delays to their treatment; and 7% reported that they had to change shifts or facilities. In 2013, in response to a question about wait times at facilities, the same proportion of patients, 14%, reported increases in wait times as decreases in wait times. This year, [...]

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DPC’s Letter to Hon. Chiquita Brooks-LaSure, Administrator for CMS, on End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2024 Proposed Rule (CMS-1782-P)

2024-03-29T01:09:16+00:00August 18th, 2023|Categories: Comment Letter, Improve Access to Care, Medicare Advantage, Protect Patient Care, Staffing Shortages|

August 18, 2023 Hon. Chiquita Brooks-LaSure, Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD  21244 Re:       End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2024 Proposed Rule (CMS-1782-P) Dear Administrator Brooks-LaSure: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced proposed rule. DPC's membership, currently about 35,000, is restricted to kidney disease patients and their family members. DPC is a patient-led organization.  Our by-laws require that the President, Vice President and at least 51% of the Board be current dialysis patients.  The non-dialysis patients serving on our Board [...]

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DPC Responds to Medicare’s Move Toward Medically Necessary Dental Care

2024-03-29T01:09:21+00:00August 26th, 2022|Categories: Access to Transplant, Article, Comment Letter, Dental Coverage, Improve Access to Care, Medicare Advantage|

DPC submitted a comment letter applauding the Center for Medicare and Medicaid Services (CMS) for its announcement that it will cover dental work for kidney transplant candidates when oral health issues are a barrier to transplant surgery. “This proposal is an important recognition and clarification of CMS’s existing authority, which will help to ensure that Medicare beneficiaries can access and afford more of the dental care they need to advance their health,” DPC said. CMS also asked whether there are “types of surgery, or clinical scenarios involving acute or chronic conditions that would have an improved patient outcome if certain dental [...]

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DPC’s Letter to Hon. Chiquita Brooks-LaSure, Administrator for CMS, on Move Toward Medically Necessary Dental Care

2024-03-29T01:09:22+00:00August 25th, 2022|Categories: Comment Letter, Dental Coverage, Medicare Advantage, Protect Patient Care|

August 25, 2022 Hon. Chiquita Brooks-LaSure, Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD  21244 Re: CMS-1770-P (Section II.L.) Dear Administrator Brooks-LaSure: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced proposed rule. DPC's membership, currently over 30,000, is restricted to kidney disease patients and their family members. DPC is a patient-led organization.  Our by-laws require that the President, Vice President and at least 51% of the Board be current dialysis patients.  The non-dialysis patients serving on our Board are former dialysis patients with kidney transplants. Our volunteer board members have represented [...]

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DPC’s Letter to Hon. Chiquita Brooks-LaSure, Administrator for CMS

2024-03-29T01:09:22+00:00August 18th, 2022|Categories: Comment Letter, Medicare Advantage, News, Protect Patient Care, Quality Incentive Program, Uncategorized|

August 18, 2022 Hon. Chiquita Brooks-LaSure, Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD  21244 Re:       End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2023 Proposed Rule (CMS-1768-P) Dear Administrator Brooks-LaSure: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced proposed rule. DPC's membership, currently over 30,000, is restricted to kidney disease patients and their family members. DPC is a patient-led organization.  Our by-laws require that the President, Vice President and at least 51% of the Board be current dialysis patients.  The non-dialysis patients serving on our Board [...]

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DPC Submits Comments on Medicare’s 2022 ESRD Payment Rule

2024-03-29T01:09:22+00:00August 18th, 2022|Categories: Article, Comment Letter, Medicare Advantage, Protect Patient Care, Quality Incentive Program|

DPC’s comment letter on Medicare’s 2022 ESRD Payment Rule highlighted the impact that labor shortages may have on dialysis patients. “Currently, there are nearly two job openings for every available unemployed worker. Vulnerable patients need a labor market in which there is a one-to-one ratio of health care workers for vacancies in essential jobs. Over the long term, the government may need to act to foster interest among young people in healthcare careers and facilitate their preparation for such roles. But in the immediate term, it is necessary to ensure that wages for jobs like dialysis technicians are competitive.” DPC is [...]

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