Dialysis Patient Citizens News
RE: CMS-1631-P: Physician Fee Schedule
August 25, 2015 Andrew Slavitt, Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue SW Washington, D.C. 20201 Dear Mr. Slavitt, Dialysis Patient Citizens (DPC) appreciates the opportunity to provide the Centers for Medicare and Medicaid Services (CMS) with comments on the proposed payment rule for the Medicare End Stage Renal Disease (ESRD) program. As America’s largest patient-led organization representing dialysis patients, DPC’s membership consists of more than 28,000 dialysis and pre-dialysis patients and their [...]
JAMA Study Examines Obstacles Preventing Kidney Transplants
It is well known that the best treatment for end-stage renal disease patients is a kidney transplant. While there are many health factors that affect a patients’ ability to receive a transplant, a recent study found that only 28 percent of adult patients beginning dialysis were even referred for kidney transplant evaluations. The study, published in the Journal of American Medical Association, examined 15,000 patients within Georgia’s three transplant centers. Referral rates varied from 0% to 75% in some dialysis facilities. Researchers found that facilities with the lowest [...]
Report Finds Star Rating System Does Not Follow Federal Guidelines
The Medicare five-star rating system, maintained by the Center for Medicaid and Medicare Services’ (CMS), has recently come under scrutiny by the Center for Regulatory Effectiveness (CRE). In a letter from last month, CRE officials report that multiple entities have contacted them about the system possibly violating federal regulations. According to the letter, data from the rating system helps in determining rebates, eligibility and bonuses for patients. Current law requires this information be posted on a federal register to receive comments from stakeholders. CRE officials found CMS has instead [...]
Biosimilar Medication Topic of House Letter to CMS
When the FDA approves a generic drug, it’s based on the chemicals contained in the original brand medication. Congress recently enacted a similar process for the approval of “biosimilars” based on the original biologic medication. The main difference is that the “biosimilar” is approved based on its development process. Biosimilars have the potential to be a cheaper alternative for expensive biologic medications such as Epogen, a drug used for anemia management. A letter sent from the House of Representatives to the Centers for Medicaid and Medicare Services (CMS) calls attention [...]
Congress Adopts Key Element of Kidney Community Agenda: Clinics May Soon Dialyze Acute Kidney Injury Patients
In passing the President's trade legislation last month, Congress enacted a longtime priority of kidney care advocates: permitting patients with acute kidney injury (AKI) to be treated in dialysis clinics. Under current law, AKI patients may only receive dialysis at hospitals, which is more costly to the Medicare program and less convenient for patients. Congress took this measure from the Chronic Kidney Disease Improvement in Research and Treatment Act, the comprehensive kidney bill that DPC has supported, so that the Medicare savings could pay for assistance to displaced [...]
DPC Submits Ideas for Improving ESRD Care to Special Senate Task Force
Earlier this spring, the U.S. Senate Finance Committee invited stakeholders to submit ideas to improve care for Medicare beneficiaries with chronic diseases. DPC submitted its comments on June 22 with a focus on how end-stage renal disease (ESRD) patients could benefit from increased care coordination among providers. The Senate Finance Committee oversees the Medicare program and both the current Chairman Orrin Hatch (R-UT) and top Democrat Ron Wyden (D-OR) have prioritized improving patient outcomes while lowering costs. They appointed a bipartisan task force to move forward with the [...]
DPC Writes to Montana state official, in support of a proposed rule allowing Medigap open enrollment for Medicare patients under the age of 65 with disabilities or ESRD
Brett O’Neill, Attorney Office of the Commissioner of Securities and Insurance Montana State Auditor 840 Helena Ave. Helena, MT 59601 RE: Medicare Supplements – ARM 6.6.507B, .507C, .507E, .511, .511A Dear Mr. O’Neill: As the nation’s largest patient-led organization representing dialysis patients, Dialysis Patient Citizens (DPC) works to improve the quality of life for all dialysis patients through education and advocacy. On behalf of our membership, and particularly on behalf of the over 750 dialysis patients in Montana, we are writing in support of the proposed rule [...]
DPC Shares Patient Perspective at Congressional Briefing
Kidney Care Partners, in coordination with the Congressional Kidney Caucus, recently hosted a briefing on Capitol Hill to stress the importance of ensuring quality kidney care now and in the future. The briefing featured opening remarks by Kidney Caucus co-chairs, Rep. Tom Marino (R-PA) and Rep. Jim McDermott (D-WA), who both emphasized the need for increased awareness and research for kidney care issues. Nancy Scott, DPC Education Center Board President, was on hand to provide the patient's perspective to the attendees. Nancy lives by the [...]
Dialysis Patients Protest Proposed Cuts at Illinois State Capitol
Kathleen Haines being interviewed by a Springfield reporter. Dialysis patients and clinicians held a press conference at the Illinois State Capitol in Springfield on May 26 to oppose cuts to Medicaid ESRD payments proposed by Governor Bruce Rauner. Two dialysis patients from central Illinois, Alan Cook and Kathleen Haines, represented Dialysis Patient Citizens at the event, which received coverage on Chicago and Springfield TV news broadcasts. More than 5,000 people, or approximately 30% of Illinois dialysis patients, use Medicaid as their primary or secondary insurance. [...]
Chronic Kidney Disease Improvement in Research and Treatment Act Gaining Momentum
While only a few weeks after its introduction, the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 1130/S. 598) is gaining new cosponsors in Congress. That said, we still have a lot of work to do to ensure this legislation is signed into law. If you want to see better care for dialysis patients, please take a few minutes to contact your Members of Congress and urge them to support this important legislation by clicking here. Representatives Tom Marino (R-PA), John Lewis (D-GA) and Peter Roskam [...]
Consumer Reports Survey Sheds Light on Unexpected Medical Bills
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 [...]
Centers for Medicare and Medicaid Services Crack Down on New Jersey Ambulance Companies that Fraudulently Bill Medicare
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 [...]
Federal Government Signals Intent to Combat Resistant Bacteria
Antibiotics are supposed to treat disease and assist in kidney transplantation, but various bacteria have developed biological resistance to antibiotics, rendering the antibiotics useless. In fact, the Centers for Disease Control (CDC) estimates that antibiotic-resistant bacteria cause two million illnesses and 23,000 deaths each year. This is why the Administration is currently taking steps to combat antibiotic-resistant bacteria. While antibiotics assist in kidney transplantation, healthcare antiseptics are supposed to reduce bacteria that can cause disease on your dialysis equipment or in your dialysis facility. These healthcare antiseptics [...]
An Overview of 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 [...]
Dialysis Patient Citizens’ Statement of Principles to Guide Formulation of Star Ratings
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 [...]
DPC Board of Directors Announces New Interim President
The DPC Board of Directors is pleased to announce that Jack Reynolds will serve as Interim President, effective immediately. Reynolds chairs the Board’s Policy Committee and previously served as Vice President. Few have the firsthand experience Reynolds does, having been on dialysis over 40 years. He took on the new role to allow former President Eric Edwards to take an extended leave of absence. Click here to read Reynold’s biography, along with that of the other DPC Board Members.
DPC Board Members to Serve on Three Technical Expert Panels
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, [...]
Urge Your Members of Congress to Take Action During National Minority Health Month
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 [...]
Permanent Medicare Physician Payment Increase Passes Congress
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 [...]
Celebrate World Kidney Day Today (March 12, 2015)
The 10th anniversary of World Kidney Day (WKD) is here! WKD was started to raise awareness of the fact that 10% of the adult population worldwide has kidney disease.The goal of WKD is to educate people on the importance of their kidneys and on the most common causes of kidney disease (high blood pressure and diabetes). The hope is to prevent kidney disease and related diseases in the first place.While our healthcare systems would benefit from reduced expenses, millions would benefit from an improved quality of life. This makes [...]