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Kidney Care Bill Introduced in U.S. House of Representatives

2024-03-29T02:08:05+00:00June 30th, 2014|Categories: Article, Care Coordination, Medicare Advantage, Treatment Options|

Congressmen John Lewis (D-GA) and Tom Marino (R-PA) have introduced the Chronic Kidney Disease Improvement in Research and Treatment Act in the U.S. House of Representatives. Lewis and Marino are leaders on the Congressional Kidney Caucus and have been staunch supporters of dialysis patients over the years. This bill seeks to advance several proactive kidney care policy initiatives and provides a vehicle for educating Members of Congress and the public about the issues facing kidney disease patients and the kidney community as a whole. The bill would: Improve understanding of kidney disease: The legislation seeks to identify the gaps in critical [...]

Quality Incentive Program in July

2024-03-29T02:08:05+00:00June 30th, 2014|Categories: Article, Quality Incentive Program|

The Center for Medicare & Medicaid Services (CMS) has an ongoing quality incentive program, the first of its kind, for End Stage Renal Disease (ESRD) care. The quality incentive program, or QIP, is intended to improve the care provided to ESRD patients by paying dialysis facilities based on the quality of care they deliver. If a facility fails to meet certain performance standards, they may receive a lower performance score, which results in lower payments to the facility. Each July, CMS releases a proposed rule with changes they suggest for the following year’s ESRD QIP. This rule is published online [...]

Kidney Community Rallies for Key Victory in Louisiana

2024-03-29T02:08:05+00:00June 3rd, 2014|Categories: Article, Charitable Premium Assistance, State Advocacy|

Recently, Blue Cross Blue Shield stopped accepting third party payments for medical premiums in the new health exchanges. This meant that dialysis patients in the state of Louisiana could not use financial assistance from organizations such as the American Kidney Fund (AKF) to subsidize their premium costs. Nearly 2,000 low-income Louisiana dialysis patients rely on help from assistance organizations to maintain their access to health insurance. For people with kidney failure, the out-of-pocket treatment costs are very high, and it is particularly challenging for a person on dialysis to remain employed because of the frequent treatment schedule (typically three times [...]

Medicare Ambulance Fraud in Los Angeles – A Specific Example

2024-03-29T02:08:05+00:00May 7th, 2014|Categories: Article, State Advocacy, Uncategorized|

The owners of Alpha Ambulance Inc. (Alpha), a now-defunct Los Angeles-area ambulance transportation company, have been sentenced in connection with a Medicare fraud scheme. Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, U.S. Attorney André Birotte Jr. of the Central District of California, Special Agent in Charge Glenn R. Ferry of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Director in Charge Bill L. Lewis of the FBI’s Los Angeles Field Office made the announcement. Aleksey Muratov, aka Russ Muratov, 32, and Alex [...]

Medicare Announces Revised ESRD Seamless Care Organization (ESCO) Program

2024-03-29T02:08:05+00:00May 5th, 2014|Categories: Article, Care Coordination|

The ESCO is based on the Accountable Care Organization model, under which providers band together to improve care and share in any savings that result from avoiding costly complications. In the case of the ESCO, the care coordination teams would consist of dialysis providers, nephrologists and any new personnel, such as nurse case managers or health coaches, brought on to assist patients. An earlier version of the ESCO, announced last year, failed to garner sufficient interest among providers. In response to input from providers and patient advocates including DPC, Medicare officials altered the terms of the program to make participation, which [...]

The Senior Medicare Patrol Program Helps Medicare Beneficiaries Prevent, Detect, and Report Health Care Fraud

2024-03-29T02:08:05+00:00May 5th, 2014|Categories: Article, Promote Financial Security|

By Ginny Paulson, SMP Resource Center Director Medicare loses billions each year due to fraud, error, and abuse. This not only compromises the Medicare Trust Fund, but individual beneficiaries’ future benefits and health are placed at risk as well. This problem is being addressed at many levels of government, including the nationwide Senior Medicare Patrol (SMP) program. SMPs work at the grass roots level in all 50 states plus Washington D.C., Guam, Puerto Rico, and the U.S. Virgin Islands. The SMP mission is to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, [...]

Re: Support for S.B. 403

2024-03-29T02:08:06+00:00May 1st, 2014|Categories: Charitable Premium Assistance, Comment Letter, State Advocacy|

Louisiana House Insurance Committee 900 North Third Street Baton Rouge, LA 70804 Re: Support for S.B. 403 Dear Chairman Cromer and Committee, As America’s largest patient-led organization representing over 27,000 members, Dialysis Patient Citizens (DPC) works to improve the quality of life of all dialysis patients through education and advocacy. Today we are writing on behalf of the over 6,000 dialysis patients in Louisiana to support S.B. 403, which allows third-party payments for premiums. BlueCross Blue Shield of Louisiana (BCBSLA) recently instituted a new policy of no longer accepting thirdparty payments for premiums. We believe this policy is detrimental to [...]

Re: Discrimination Against Dialysis Patients by BlueCross Blue Shield of Louisiana

2024-03-29T02:08:06+00:00April 8th, 2014|Categories: Charitable Premium Assistance, Comment Letter, State Advocacy|Tags: |

Phyllis Borzi, Assistant Secretary Employee Benefits Security Administration Department of Labor Washington, DC John P. Albert, Director Division of Medicare Secondary Payer Policy Centers for Medicare and Medicaid Services Baltimore, MD Re: Discrimination against dialysis patients by BlueCross Blue Shield of Louisiana Dear Ms. Borzi and Mr. Albert: As America’s largest patient-led organization representing over 27,000 members, Dialysis Patient Citizens (DPC) works to improve the quality of life of all dialysis patients through education and advocacy. Today we are writing on behalf of the over 6,000 dialysis patients in Louisiana to request inquiries into the new BlueCross Blue Shield of [...]

Dialysis Reimbursements Stabilized by Protecting Access to Medicare Act

2024-03-29T02:08:06+00:00April 2nd, 2014|Categories: Article, Dialysis Funding, Immunosuppressive Drug Coverage|

This week President Obama signed the Protecting Access to Medicare Act, which contained some provisions favorable to dialysis patients. The primary purpose of the legislation was to stabilize Medicare payments to physicians, but Congress also used the opportunity to stabilize reimbursements to dialysis facilities. A large cut that had been scheduled to take effect in 2016 has been replaced by smaller, fixed-amount cuts that afford providers more certainty about revenues in coming years. This new payment formula will encourage providers to renew expiring leases on dialysis facilities and continue to invest in improved kidney care infrastructure. Another provision further delays addition [...]

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