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

2024-03-29T01:50:33+00:00May 14th, 2015|Categories: Article, State Advocacy, 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 [...]

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

2024-03-29T01:50:34+00:00November 13th, 2014|Categories: State Advocacy, 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 [...]

DPC Urges Administration to Keep Dialysis Accessible in Obamacare Health Plans

2024-03-29T02:08:06+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 [...]

DPC Comments on Medicaid Advantage Drive Times

2024-03-29T02:09:00+00:00January 24th, 2013|Categories: Comment Letter, Transportation Services|

January 24, 2013 Jonathan Blum Deputy Administrator and Director for the Center of Medicare Centers for Medicare and Medicaid Services Department of Health and Human Services Room 314G 200 Independence Avenue, SW Washington, DC 20201 Re: Medicaid Advantage Drive Times for ESRD Patients Dear Mr. Blum: On behalf of more than 24,000 Dialysis Patient Citizens (DPC) members and over 400,000 end-stage renal disease (ESRD) patients currently on dialysis, thank you for your leadership at the Centers for Medicare and Medicaid Services (CMS).  As the nation’s largest patient-led organization representing dialysis patients, DPC’s membership consists of dialysis and pre-dialysis patients and their [...]

Congressional Corner: Over the Cliff – Then Quickly Back Up Again

2024-03-29T02:09:00+00:00January 3rd, 2013|Categories: Blog, Immunosuppressive Drug Coverage, Transportation Services|

By Carrie L., Director of Congressional and State Relations Well, we went over the fiscal cliff. And then, just hours later a deal was struck, a few hours late but a deal to bring us back from the brink nonetheless. The 112th Congress concluded its tumultuous, and gridlocked 2 years by passing a deal to avoid massive tax hikes for the middle class and a 27% decrease in payments to Medicare providers on New Year’s Day. Unfortunately, cuts to the Medicare ESRD program were still included in the fiscal cliff package. The deal calls on the Centers for Medicare and Medicaid [...]

Congressional Corner: A Year of DPC Advocacy Successes!

2024-03-29T02:09:00+00:00December 12th, 2012|Categories: Immunosuppressive Drug Coverage, Medicaid, State Advocacy, Transportation Services|Tags: , |

By Carrie L., Director of Congressional and State Relations As 2012 comes to an end, DPC has a lot to celebrate and a lot to look forward to. DPC staff and most importantly our members, have achieved so much this year, bringing awareness to kidney disease issues both in Congress and in their communities! Patient Ambassadors held dozens of kidney and dialysis awareness events across the country in support of World Kidney Day and other events throughout the year. Patient Ambassadors taught members of their churches and civic organizations as well as youth in schools about the importance of keeping your [...]

DPC Comments on MATP Co-payment

2024-03-29T02:09:26+00:00March 5th, 2012|Categories: Comment Letter, State Advocacy, Transportation Services|

March 5, 2012 Department of Public Welfare c/o Regulations Coordinator Room 515 Health and Welfare Building Harrisburg, PA 17120 RE: Proposed Co-payment for Medical Assistance Transportation Program To Whom It May Concern: As America’s largest patient-led organization representing dialysis patients, Dialysis Patient Citizens (DPC) works to improve the quality of life for all dialysis patients through advocacy and education. We are writing today on behalf of the over 14,000 dialysis patients in Pennsylvania, specifically those who utilize the State’s Medical Assistance Transportation Program (MATP). This program provides vital transportation for patients to and from dialysis treatments and adding a co-payment [...]

DPC Comments on Medicare Advantage Drive Times

2024-03-29T02:09:26+00:00February 24th, 2012|Categories: Comment Letter, Transportation Services|

February 24, 2012 Jonathan Blum Deputy Administrator and Director for the Center of Medicare Centers for Medicare and Medicaid Services Department of Health and Human Services Room 314G 200 Independence Avenue, SW Washington, DC 20201 Re: Time and Distance Criteria for Outpatient Dialysis Dear Mr. Blum: As the nation’s leading kidney disease and dialysis patient advocacy organizations, we appreciate the opportunity to provide comments on the recent changes to the Time and Distance Criteria for Outpatient Dialysis. Each year in the United States, more than 100,000 Americans are diagnosed with end stage renal disease (ESRD), an irreversible condition which is fatal [...]

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