ESRD Network – Your Resource for Access to Care

2020-04-27T16:40:23+00:00April 27th, 2020|Categories: Article, Improve Access to Care, Medicaid, Medicare Advantage, News, Transportation Services|

The Centers for Medicare & Medicaid Services (CMS), which is the federal Agency that oversees the Medicare program, recently reiterated its commitment to ensuring dialysis patient access to care during the current pandemic. They said that if any dialysis patients are having problems with transportation, that prevent you from getting to dialysis, they want to help. CMS also knows that your dialysis access is your lifeline, so if you have any complications with your fistula, graft or catheter and need help – that is why they created the End Stage Renal Disease (ESRD) Network Program – to help patients. So, while [...]

COVID-19 Resources for Dialysis Patients

2020-04-08T22:04:06+00:00March 31st, 2020|Categories: Article, Promote Financial Security, Transportation Services|Tags: |

Here is a list of resources for dialysis patients to help them get additional support during the COVID-19 viral outbreak and beyond. Resource topics include: disability, financial assistance, nutrition, healthcare, housing and utilities, jobs, transportation, women and children, daily living, and staying safe. In addition, visit your state department of health website for COVID-19 information that is specific to your area.

DPC Supports Increased Access and Quality of Care for Dialysis Patients Amid COVID-19

2020-04-02T14:09:49+00:00March 23rd, 2020|Categories: Care Coordination, Comment Letter, Increase Quality of Care, Medicare Advantage, Transportation Services, Treatment Options|Tags: |

DPC provided feedback to the U.S. Department of Health and Human Services (HHS) regarding the COVID-19-related issues that the kidney community is facing. DPC made recommendations to HHS in the following areas: Transportation COVID-19 Treatments and Vaccinations Home Dialysis People with End-Stage Renal Disease have a higher risk for developing a severe illness from COVID-19. As a result, it is crucial we do all that we can to help this vulnerable population in order to decrease the negative impact and spread of the virus. Read DPC's letter to HHS below for more details: Kumiko Lippold, PhD, MPH Department of Health [...]

Happy Holidays and DPC’s Top 10 Accomplishments of 2019

2020-03-21T20:40:48+00:00December 20th, 2019|Categories: 5-Star Ratings, About DPC, Access to Transplant, Article, Care Coordination, Charitable Premium Assistance, Dental Coverage, Dialysis Funding, Immunosuppressive Drug Coverage, Innovation, Medicaid, Medicare Advantage, Medigap Coverage, Quality Incentive Program, Transplant Donor Protection, Transportation Services, Treatment Options|

Dialysis Patient Citizens wants to wish you and your family a Happy Holiday, as well as a safe and healthy New Year. Our offices will be closed for the holidays starting December 23 through January 1. We also want to take this opportunity to share our list of Top 10 Accomplishments for 2019, which would not have been possible without your support. Thank you again for helping us elevate the dialysis patient voice with policy makers. We are extremely grateful for all of your advocacy efforts, and we look forward to our continued collaboration in 2020 as we work together to improve dialysis [...]

DPC Submits Comments on Market Stabilization

2020-03-21T20:43:09+00:00March 9th, 2017|Categories: Comment Letter, Transportation Services|

A recent proposed rule released by the Centers for Medicare & Medicaid Services (CMS) provided guidance for market stabilization of the Affordable Care Act.  Within this proposed rule, network adequacy provisions for dialysis clinics provided a narrow scope for insurers. In comments submitted by DPC on March 6, we argued stronger time and distance criteria need to be added to these provisions. Research shows there is little difference between living in a metropolitan area compared to living in a rural environment, but there are significant mortality risks associated with actual distance from a dialysis facility. Additionally, after only 15 minutes of [...]

DPC Urges CMS to Prioritize Patient Access

2020-03-21T20:44:57+00:00January 19th, 2016|Categories: Access to Transplant, Care Coordination, Charitable Premium Assistance, Medicare Advantage, Medigap Coverage, Transportation Services|Tags: |

Last month, DPC sent a letter commenting on the “Notice of Benefit and Payment Parameters for 2017” proposed rule. This annual rule by the Centers for Medicare and Medicaid Services (CMS) contains proposed changes to the exchange plan coverage of the Affordable Care Act. DPC’s letter focuses on the importance of insurance coverage and network quality for end-stage renal disease (ESRD) patients. One issue the letter comments on pertains to network adequacy. Network adequacy describes an insurance plan’s ability to provide a sufficient amount of in-network providers to subscribers in the plan. Suggestions to improve network adequacy include requiring all [...]

CMS to Expand Prior Authorization of Transportation Services to Six More States

2020-03-21T20:44:57+00:00November 9th, 2015|Categories: Transportation Services|

The Centers for Medicare and Medicaid Services (CMS) will begin expanding a prior authorization model for non-emergency ambulance transportation for dialysis patients into six states: Maryland, Delaware, the District of Columbia, North Carolina, Virginia and West Virginia. The program expansion will begin on January 1, 2016 and requires ambulance providers in those states to obtain documentation from physicians prior to beginning service. CMS plans to reach out to ambulance providers and Medicare beneficiaries about the program through educational materials. This model was originally implemented in New Jersey, Pennsylvania and South Carolina. It came in response to fraud cases found in those states, in [...]

Centers for Medicare and Medicaid Services Crack Down on New Jersey Ambulance Companies that Fraudulently Bill Medicare

2020-03-21T20:45:20+00:00May 14th, 2015|Categories: Article, Transportation Services|

The Centers for Medicare and Medicaid Services (CMS) is continuing a four-month crackdown on Medicare fraud in New Jersey. CMS has accused ambulance companies of fraudulently billing Medicare for transporting patients to non-emergency dialysis, chemotherapy and wound care. CMS found that these ambulance trips in New Jersey were twice the national average (from 2002 to 2011), and that the number of trips per patient was up approximately 60%. At least 11 ambulance companies report closing in recent months. The ambulance companies in New Jersey are now required to obtain pre-authorization from Medicare to transport a given patient, and many of these [...]

Prior Authorization of Non-Emergency Ambulance Transportation to Begin for Dialysis Patients in New Jersey, Pennsylvania and South Carolina

2020-03-21T20:46:10+00:00November 13th, 2014|Categories: Transportation Services|

The Centers for Medicare & Medicaid Services (CMS) will begin implementing a prior authorization demonstration program for non-emergent ambulance transport of dialysis patients in New Jersey, Pennsylvania and South Carolina. CMS believes using a prior authorization process will help ensure services are provided in compliance with Medicare coverage rules, specifically that ambulance providers in those states must obtain documentation from physicians prior to the beginning of service. The requirement does not apply to hospital-based ambulances. CMS is taking these actions in response to instances of fraud in those three states. For example, one Pennsylvania fraud scheme involved more than $3.6 million [...]

DPC Urges Administration to Keep Dialysis Accessible in Obamacare Health Plans

2020-03-21T20:46:58+00:00March 6th, 2014|Categories: Article, Comment Letter, Transportation Services|

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, in order to obtain lower prices—patients may not have access to the clinic [...]