Dialysis Patient Citizens News
Congress needs to protect kidney patients following Supreme Court decision
I recently joined other dialysis patients in meetings with Congress to discuss the challenges we face. One of the key topics we covered was how hard it is for patients to get access to the benefits and coverage we need just to survive. Those challenges are about to get much bigger for many patients after a recent Supreme Court decision. The decision could limit benefits and make it easier for private insurers to move patients off their employer-sponsored coverage and onto Medicare before the traditional 30-month point [...]
DPC Responds to Medicare’s Move Toward Medically Necessary Dental Care
DPC submitted a comment letter applauding the Center for Medicare and Medicaid Services (CMS) for its announcement that it will cover dental work for kidney transplant candidates when oral health issues are a barrier to transplant surgery. “This proposal is an important recognition and clarification of CMS’s existing authority, which will help to ensure that Medicare beneficiaries can access and afford more of the dental care they need to advance their health,” DPC said. CMS also asked whether there are “types of surgery, or clinical scenarios involving acute [...]
DPC’s Letter to Hon. Chiquita Brooks-LaSure, Administrator for CMS, on Move Toward Medically Necessary Dental Care
August 25, 2022 Hon. Chiquita Brooks-LaSure, Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Re: CMS-1770-P (Section II.L.) Dear Administrator Brooks-LaSure: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced proposed rule. DPC's membership, currently over 30,000, is restricted to kidney disease patients and their family members. DPC is a patient-led organization. Our by-laws require that the President, Vice President and at least 51% of the Board be current dialysis patients. The non-dialysis patients serving on our Board [...]
Dialysis patients need expanded coverage for leftover costs
In 2017, I had a below-knee leg amputation, during which it was discovered my kidneys had deteriorated. These health crises forced me to undergo physical rehabilitation and begin dialysis treatments for my kidneys. While receiving dialysis, I started writing my book on navigating midlife, which was a form of mental therapy. My book discusses my triumphs and trials as an amputee on dialysis. One of the struggles that I faced, and other kidney patients do as well, is covering the 20% of dialysis that Medicare doesn’t cover. [...]
Action Alert – Protect ESRD Patient Access to Private Coverage
Ask your representative to co-sponsor H.R. 8594/S. 4750, legislation that would protect ESRD patients by allowing them to maintain private, employer health coverage up to 30 months after diagnosis with kidney failure. A recent Supreme Court ruling now threatens their access to private coverage by permitting health plans to carve off dialysis benefits from their networks and impose restrictive terms on kidney patients. The continuation of high-quality care and benefits during this 30-month coordination period helps kidney patient’s successfully transition into life on dialysis and/or kidney transplantation. Leave your legacy through advocacy [...]
DPC’s Letter to Hon. Chiquita Brooks-LaSure, Administrator for CMS
August 18, 2022 Hon. Chiquita Brooks-LaSure, Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Re: End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2023 Proposed Rule (CMS-1768-P) Dear Administrator Brooks-LaSure: Dialysis Patient Citizens (DPC) writes to offer its comments on the above referenced proposed rule. DPC's membership, currently over 30,000, is restricted to kidney disease patients and their family members. DPC is a patient-led organization. Our by-laws require that the President, Vice President and at least 51% of [...]
DPC Submits Comments on Medicare’s 2022 ESRD Payment Rule
DPC’s comment letter on Medicare’s 2022 ESRD Payment Rule highlighted the impact that labor shortages may have on dialysis patients. “Currently, there are nearly two job openings for every available unemployed worker. Vulnerable patients need a labor market in which there is a one-to-one ratio of health care workers for vacancies in essential jobs. Over the long term, the government may need to act to foster interest among young people in healthcare careers and facilitate their preparation for such roles. But in the immediate term, it is necessary [...]
Dialysis patients counting on Congress
It’s quite the experience being a kidney patient on dialysis. There’s always new information to monitor and communication to track between various medical providers, dialysis centers, and health insurance entities. It’s important for patients to educate themselves on kidney disease to best serve themselves and others who are on dialysis. One area of dialysis that can be hard to navigate is health care coverage. As both a dialysis patient and transplant recipient, I’ve been fortunate to have both employer-sponsored insurance and coverage through the Department of Veterans [...]
Medigap bill can help kidney patients
When I started helping my dad after his kidney disease diagnosis, I thought it would be straightforward, taking him to the dialysis clinic and just generally caring for him. As I started learning more about the challenges kidney patients face, though, I remember looking around at all of the younger patients at his dialysis clinic and asking myself, “How on earth are they paying for this?” The answer for too many is that they can’t. In many states, Medicare only covers up to 80% of dialysis treatment, [...]
Dialysis Patient Citizens Applauds New Legislation Prohibiting Discrimination Against Dialysis Patients
WASHINGTON, D.C. (August 1, 2022) -- Dialysis Patient Citizens (DPC) today released the following statement applauding the introduction of H.R. 8594 by Representatives Yvette Clarke (D-NY-9), Buddy Carter (R-GA-1), Jodey Arrington, (R-TX-19), and Danny Davis (D-IL-7) to prohibit discrimination against dialysis patients in insurance coverage. “We thank Representatives Clarke, Carter, Arrington, and Davis for introducing this essential piece of legislation that will protect dialysis patients from facing unjust discrimination in their health coverage,” said DPC Board President Andrew Conkling. “Dialysis patients have a right to continue on [...]
Rhode Island Medigap Legislation Signed by Governor McKee
On June 30,2022, Rhode Island Governor Dan McKee signed into law H. 7244 and S. 2194, which provide guaranteed issue access to Medicare Supplement Insurance coverage – known as Medigap – for under age 65 residents with End Stage Renal Disease (ESRD) and qualified disabled. The legislation becomes effective July 1, 2023. The new law also provides premium protections through the premium rate review process of the Office of the State Health Insurance Commissioner. While DPC is disappointed that this legislation limits access only to Medicare Supplement Plan [...]
Legislation Offers Hope for Kidney Patients Struggling with Coverage
Kidney disease is a life-changing diagnosis for patients and their families. I experienced it first-hand as my husband went through dialysis and a kidney transplant, and I continue to see it every day working with kidney patients who are facing issues with treatments and cost. One of the most heartbreaking realities I see working with patients is that many are held back because they can’t get affordable coverage for the treatments they need to stay alive, since Medicare only covers part of the cost. That’s why we [...]
Dialysis Patients
Life with kidney disease while I was working in the United Arab Emirates was very different compared to what it is in the U.S. I had to receive all of my treatments in the hospital, and because the coverage options available weren’t the same as they are here, I had to pay for my treatments out of pocket. I felt I could get better options moving back to the U.S., but it was still remarkably expensive. Because Medicare only covers 80% of the cost of treatment, I [...]
Letter to the editor: Much-needed relief for dialysis patients
How much money do you make in an average year? Think about it for a minute. Now, imagine that entire annual salary, and then some, is gone in a month. Why, you may ask? Because those are the costs dialysis patients incur on a monthly basis. While all dialysis patients are covered by traditional Medicare, this only covers 80 percent, leaving patients to try to find a way to pay for the rest. One point four million dollars. That is the amount billed to my secondary insurance, [...]
Congress needs understanding
I was devastated when I wound up in the emergency room and found out my kidneys had failed. I was immediately placed on dialysis and began a new way of life. My new reality meant spending many hours per week at my dialysis center receiving life-saving treatments. Dialysis treatments can be costly. Medicare will only cover up to 80% of the costs, and my options are limited for covering the rest since I’m under 65. I am lucky to have had assistance from the American Kidney Fund [...]
Medicare Dental Coverage for Transplant Candidates May be on the Way
The Centers for Medicare & Medicaid Services (CMS) is proposing expanded coverage of “medically necessary” dental treatment, including treatments necessary to qualify for an organ transplant. DPC and other consumer advocates have been pressing for this change for several years. Medicare currently pays for dental services in a limited number of circumstances, such as when that service is an integral part of specific treatment of a beneficiary’s primary medical condition. Some examples include reconstruction of the jaw following accidental injury, tooth extractions done in preparations for radiation treatment [...]
Medicare Proposes Small Pay Increase for Dialysis Facilities
On June 21, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update payment rates and policies under the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries for the year beginning January 1, 2023. Under the ESRD PPS for 2023, Medicare expects to pay $8.2 billion to approximately 7,800 ESRD facilities for furnishing dialysis services. The proposed 2023 ESRD PPS base rate is $264.09, which would be an increase of $6.19 to the current [...]
LETTER: Making a difference for kidney patients
DEAR EDITOR: I recently participated in my second advocacy day meetings as part of Dialysis Patient Citizens, and am still overjoyed with the discussions I had with several of our distinguished members of Congress and their staff. I spoke briefly about how my own experience as a dialysis patient took away so much of my independence, and what so many patients have to deal with daily just to stay healthy, on top of appointments and unforeseen hospitalizations. These can seriously affect patients, especially when dealing with hospital [...]
Rhode Island Passes Medigap Access Legislation
On Thursday, June 23, 2022, the Rhode Island General Assembly held the final vote leading to passage of two bills granting access to Medigap coverage for dialysis patients under age 65. Sponsored by Rep. Brian Patrick Kennedy (D-District 38), Speaker Pro Tempore, and Senator Dennis L. Algiere (R-District 38), Senate Minority Leader, H 7244 and S 2194 require that Medicare supplement policies be made available to any applicant under age 65 eligible for Medicare due to a disability or End Stage Renal Disease (ESRD). The legislative language in [...]
Supreme Court Erases Kidney Patients’ Insurance Protections
A U.S. Supreme Court ruling has nullified the law that protects dialysis patients from discrimination by insurers, threatening the system of financing kidney care that has stood for 40 years. The Court ruled that employer health plans may limit dialysis benefits. For four decades, employers understood the law as prohibiting limitations that only applied to dialysis. Some health benefit consultants encouraged a few small employers to disregard the law by paying no more than Medicare rates for dialysis. DaVita sued them, and one of the cases was [...]