Policy Issues Archives - Page 51 of 61 - Dialysis Patient Citizens

Department of Health & Human Services Announces Pay-for-Performance Goals

Hannah Bracamonte2024-03-29T01:50:34+00:00February 4th, 2015|Categories: Article, Quality Incentive Program|

The US Department of Health & Human Services (HHS) recently announced goals for shifting the traditional fee-for-service Medicare payment model to a pay-for-performance model. In a pay-for-performance model, payment is based on the quality rather than quantity of care provided. One HHS goal is to tie 30% of fee-for-service Medicare payments to quality through alternative payment models like Accountable Care Organizations or bundled payments by the end of 2016, and 50% by the end of 2018. The dialysis community has a unique history in this area. Dialysis providers did not used to receive an annual update in their Medicare payments, but [...]

Affordable Care Act Enrollment Reaches 9.5 Million as February 15 Deadline Approaches

Hannah Bracamonte2024-03-29T01:50:34+00:00February 4th, 2015|Categories: Promote Financial Security|Tags: Affordable Care Act|

Open enrollment for individual coverage in the Affordable Care Act (ACA)’s public health insurance exchanges began in November of last year. The deadline for enrollment is February 15, 2015. So far approximately 9.5 million people have either newly enrolled or re-enrolled in the exchanges, with 7.1 million enrolling in the 37 states that use the federal marketplace, HealthCare.gov. Of those 7.1 million, approximately 6.2 million received financial assistance to help pay for coverage. Also, 4.16 million re-enrolled in health plans, and 3 million selected a plan for the first time. Again, thank you to the patients who have shared stories with [...]

Insights with Jack: Accidental Advocate

Hannah Bracamonte2024-03-29T01:50:34+00:00February 2nd, 2015|Categories: About DPC, Dialysis Funding, Get Involved, Patient's Voice|

By Jack Reynolds, DPC Board Member and Patient Ambassador As it is Ground Hog Day, I thought I would come out of my winter hole and blog once more. March is only four weeks away, and it will be time to visit Washington, D.C. and another chance for Dialysis Patient Citizen Ambassadors to bring our issues and concerns to our elected Congressional Representatives and Senators. Although I have made this journey many times since 2005, I am not a “natural” political advocate; and in fact, if not for a social worker, I may have never become a dialysis citizen at large [...]

DPC Joins Patient Groups in Commenting on the Standardized Readmission Ratio for Dialysis Facilities

Hannah Bracamonte2024-03-29T01:50:34+00:00December 22nd, 2014|Categories: Comment Letter, Quality Incentive Program|

Dialysis Facility Compare Star Ratings Draw First Challenge to CMS Quality Measures Under Data Quality Act

Hannah Bracamonte2024-03-29T01:50:34+00:00December 16th, 2014|Categories: 5-Star Ratings, Press Release|

Skewed geographic distribution of star ratings demonstrates program’s flaws, says Dialysis Patient Citizens WASHINGTON, D.C. (Dec. 16, 2014) — Dialysis Patient Citizens has filed the first challenge to a CMS quality program under the Data Quality Act, contending that the agency’s Dialysis Facility Compare (DFC) star ratings methodology fails to satisfy federal requirements for objectivity and utility in presenting information to the public. The day after being served with the complaint, CMS conceded it should have conducted cognitive testing of this system on consumers, reversing a position the agency had defended for nearly four months. “We felt this challenge was necessary in light of CMS’ continued refusal to [...]

DPC’s Request for Correction complaint to CMS Regarding DFC Star Ratings

Hannah Bracamonte2024-03-29T01:50:34+00:00December 2nd, 2014|Categories: 5-Star Ratings, Comment Letter|

Attached is CCSQ’s courtesy copy of the Request for Correction we filed today under the Data Quality Act challenging the methodology to be used in the DFC Star Ratings. The Data Quality Act and the HHS Information Quality Guidelines promulgated pursuant to the Act have been in existence for approximately as long as CMS has collected and reported quality measures. Over the past decade, no stakeholder has ever filed a Request for Correction with CMS pertaining to quality measurements. We take no joy in being the first, but we feel that the circumstances surrounding the formulation of this program—the lack of [...]

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

Hannah Bracamonte2024-03-29T01:50:34+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 [...]

New Dialysis Quality Rules May Bring Small but Noticeable Changes to Your Care

Hannah Bracamonte2024-03-29T01:50:35+00:00November 13th, 2014|Categories: Article, Quality Incentive Program|

The Centers for Medicare and Medicaid Services (CMS) recently finalized the payment rule for the Medicare End Stage Renal Disease (ESRD) program for 2015. Payment rates will stay the same next year. However, changes to the Quality Improvement Program (QIP) system of "pay for performance" are intended to prioritize new aspects of care for ESRD patients; providers are graded on each element of the "QIP" and receive payment reductions if they don't meet Medicare's standard. This means that providers are expected to add emphasis to these new areas in their interactions with patients. Here are some of the new areas being [...]

CMS Responses to Questions and Comments about the Dialysis Facility Compare Star Rating System

Hannah Bracamonte2024-03-29T01:50:35+00:00October 1st, 2014|Categories: 5-Star Ratings, Comment Letter|

CMS thanks the community for their comments and questions about the DFC Star Rating System. All comments have been given serious consideration. This document provides responses to the questions and issues raised by the ESRD community. CMS believes that the Star Rating System will empower consumers with additional quality information. It will also encourage providers to continuously achieve higher quality care. With future releases and enhancements to the DFC website, we will continue fostering an open dialogue to facilitate providing better care for all patients receiving chronic dialysis. We look forward to working with the ESRD community over the coming months [...]

Response Memo: FAQs Regarding Medicare and the Health Insurance Marketplace

Hannah Bracamonte2024-03-29T01:50:35+00:00September 24th, 2014|Categories: Comment Letter, Promote Financial Security|Tags: Health Insurance Exchange|

To: James Canavan, Center for Medicare, Centers for Medicare & Medicaid Services Spencer Manasse, Center for Consumer Information and Insurance Oversight, CMS Vicki Gottlich, Administration for Community Living Gene Coffey, Center for Medicaid and CHIP Services, CMS Janet Miller, Office of Communications, CMS Sharon Donovan, Medicare-Medicaid Coordination Office, CMS Re: Comments on “Frequently Asked Questions Regarding Medicare and the Marketplace” We appreciate that the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) arranged a July meeting for beneficiary advocates to discuss our questions and concerns related to beneficiary transitions from coverage options created under [...]

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