Policy Issues Archives - Page 51 of 62 - Dialysis Patient Citizens

Consumer Reports Survey Sheds Light on Unexpected Medical Bills

Hannah Bracamonte2024-03-29T01:50:33+00:00May 14th, 2015|Categories: Article, Promote Financial Security|

If you recently received an unexpected medical bill, you are not alone. The Consumer Reports National Research Center recently conducted a survey which found that nearly one-third of Americans with private health insurance received a surprise medical bill in the last two years. In most cases, patients went to a hospital within their insurance plan’s network, but were treated by a physician who had not contracted with the insurer. Many privately insured Americans regularly face the issue of reimbursement, or lack thereof, for treatment by doctors outside their insurance plan’s network. Only 28% of privately insured Americans surveyed by Consumer [...]

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

Hannah Bracamonte2024-03-29T01:50:33+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 [...]

An Overview of Medigap Coverage

Hannah Bracamonte2024-03-29T01:50:33+00:00May 7th, 2015|Categories: Article, Medigap Coverage|

Current Situation Currently, two populations qualify for Medicare: those over the age of 65, and those under the age of 65 who meet certain federal conditions. A diagnosis of End Stage Renal Disease (“ESRD”) satisfies these conditions and makes ESRD patients under age 65 eligible for Medicare. Medicare requires the patient pay deductibles and co-pays. If patients cannot afford these costs, they may become state Medicaid eligible by virtue of income level or after spending down their assets. The Problem Many ESRD Medicare beneficiaries can’t afford to pay Medicare deductibles and co-pays. As a result, many of them spend down their [...]

Dialysis Patient Citizens’ Statement of Principles to Guide Formulation of Star Ratings

Hannah Bracamonte2024-03-29T01:50:33+00:00April 21st, 2015|Categories: 5-Star Ratings, Article|

Dialysis Patient Citizens (DPC) endorses the following six principles to guide formulation of star ratings for Dialysis Facility Compare: Star ratings must use metrics that represent aspects of care that are important to patients. Star ratings should not simply rely upon any information that happens to be available; patient priorities should be ascertained and reflected in the ratings. Star ratings must drive improvement. Facilities should be held to absolute standards. They must be able to improve their scores through improved quality regardless of how competing facilities perform. Competition among facilities should be realistic, e.g., facilities in regions with generally poor health [...]

DPC Board Members to Serve on Three Technical Expert Panels

Hannah Bracamonte2024-03-29T01:50:33+00:00April 7th, 2015|Categories: 5-Star Ratings, Access to Transplant, Treatment Options|

The Centers for Medicare and Medicaid Services (CMS) regularly schedules technical expert panels (TEPs) to advise the agency on quality measures. In the words of CMS, a TEP is “a group of stakeholders and experts who provide technical input…on the development, selection, and maintenance of measures for which CMS contractors are responsible.” CMS is contracting with the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) to host a TEP on the Dialysis Facility Compare star rating system. While the complete roster of participants is not public yet, we are pleased to announce that DPC Interim President Jack Reynolds was selected [...]

Urge Your Members of Congress to Take Action During National Minority Health Month

Hannah Bracamonte2024-03-29T01:50:33+00:00April 7th, 2015|Categories: Care Coordination, Dialysis Funding, Medicare Advantage|

April is National Minority Health Month, an issue of vital importance for dialysis patients since even greater health disparities are reflected in the dialysis patient community. For example, African Americans are 3.5 times more likely to develop kidney failure than non-Hispanic white Americans, Hispanic Americans are 1.5 times more likely and Native Americans are 1.7 times more likely. Asian Americans are also more likely to develop kidney failure. Click here to urge your Members of Congress to co-sponsor the Chronic Kidney Disease Improvement in Research and Treatment Act (S. 598 and H.R. 1130), which includes a key provision supporting research on kidney health [...]

Permanent Medicare Physician Payment Increase Passes Congress

Hannah Bracamonte2024-03-29T01:50:33+00:00April 7th, 2015|Categories: Dialysis Funding, Medigap Coverage|

Congress recently passed the Medicare Access and CHIP Reauthorization Act, also known as the permanent “doc fix” bill. The bill passed the House of Representatives 392-37 and the Senate 92-8, with strong bipartisan support. The White House has announced President Obama’s intent to sign the bill into law. Those who voted in favor of the bill felt it was necessary to permanently replace the current Medicare physician payment formula. In 1997, Congress passed a formula known as the sustainable growth rate (SGR) formula, which unexpectedly dictated regular pay cuts for doctors. In 2003, many in Congress began to fear that the [...]

What are Dialysis Patients’ Priorities for Quality Information? Insights from DPC Patient Survey

Hannah Bracamonte2024-03-29T01:50:33+00:00March 11th, 2015|Categories: 5-Star Ratings, Article, Quality Incentive Program|

After the Centers for Medicare and Medicaid Services (CMS) announced its plans to release the Dialysis Facility Compare star rating system, DPC began to discuss with its membership what would make such a rating system successful. The two areas that DPC’s Board Members, Patient Ambassadors and membership all rated highest were 1) staff respect/listening and 2) patient education. Staff Respect/Listening: This topic compresses two questions from the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) questionnaire that Medicare requires dialysis patients to complete. It was even more apparent during our focus group discussions of our survey responses how upset [...]

Urge Your Members of Congress to Co-Sponsor the Chronic Kidney Disease Improvement in Research and Treatment Act!

Hannah Bracamonte2024-03-29T01:50:33+00:00March 11th, 2015|Categories: Care Coordination, Dialysis Funding, Medicare Advantage|

Senators Ben Cardin (D-MD), Mike Crapo (R-ID) and Bill Nelson (D-FL) were joined by Representatives Tom Marino (R-PA), John Lewis (D-GA) and Peter Roskam (R-IL) in introducing the Chronic Kidney Disease Improvement in Research and Treatment Act (S. 598/H.R. 1130) to improve the health of kidney patients. If passed, this bill would provide access to Medicare Advantage (MA) plans for dialysis patients. This bill would also enhance current research efforts related to chronic kidney disease (CKD) by: Requiring the Government Accountability Office (GAO) to calculate the overall cost of CKD care, ensure that federal funding for CKD research is appropriate relative to [...]

DPC Fly-In Participants Lobby Members of Congress Despite Snow Storm, Government Closure
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DPC Fly-In Participants Lobby Members of Congress Despite Snow Storm, Government Closure

Hannah Bracamonte2024-03-29T01:50:33+00:00March 11th, 2015|Categories: Article, Medicare Advantage|Tags: Advocacy Day|

DPC’s annual Kidney Month fly-in was held last Wednesday and Thursday (March 4 & 5). Patient advocates from across the country flew to Washington, DC to speak with their Members of Congress on issues critical to their care. And despite numerous obstacles, they made sure their voices were heard. On March 4, patient advocates participated in an in-depth advocacy training, as many were going to Capitol Hill for the first time. This training helped to ensure that participants had the information and confidence to discuss the importance of preserving dialysis funding as well as why dialysis patients should be allowed [...]

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