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DPC Calls on Regulators to Investigate Insurer’s Renal Care Coverage Limitations

2020-09-24T17:35:08+00:00October 9th, 2015|Categories: Article, Promote Financial Security, State Advocacy|Tags: |

Kidney advocates are reacting to an alarming trend in the commercial insurance industry: insurers are increasingly writing language into policy documents that attempt to exclude or limit coverage of renal care. DPC is alerting regulators at both the state and federal levels to the harm these limitations could have on patients and asking them to enforce the numerous laws that prohibit health plans from discriminating against people with ESRD. Federal law guarantees that ESRD patients may keep their private insurance coverage for up to 30 months before enrolling in Medicare. The law also requires that health plans cannot differentiate between [...]

DPC, Kidney Patient, Testify at Hearing on Surprise Medical Bills

2020-09-24T17:36:41+00:00October 9th, 2015|Categories: Article, Legal Defense, Promote Financial Security, State Advocacy|Tags: |

DPC Policy Director Jackson Williams and Pittsburgh kidney patient Janice Nathan were among witnesses at a hearing held by Pennsylvania’s insurance commissioner on “surprise medical bills.” These are bills received from physicians who are outside of an insurer’s provider network even though they work inside facilities that are in-network. Janice Nathan’s primary care doctor recommended that she receive a cardiac stress test. Ms. Nathan checked her insurer’s provider directory and found an in-network facility to get the test. But when she received a cardiologist’s bill for $325—much more than the $50 co-pay she expected—she learned that the cardiologist who read [...]

Re: Essential Health Benefits – 2017 Benchmark Plans

2020-03-21T20:45:20+00:00September 28th, 2015|Categories: Care Coordination, Comment Letter, Promote Financial Security|Tags: |

Hon. Kevin Counihan Center for Consumer and Information and Insurance Oversight Centers for Medicare and Medicaid Services Hubert H. Humphrey Building 200 Independence Ave, SW Washington, D.C. 20201 Re: Essential Health Benefits - 2017 Benchmark Plans Dear Deputy Director Counihan: Dialysis Patient Citizens, America’s largest patient-led organization representing dialysis patients, is comprised of more than 28,000 dialysis and pre-dialysis patients and their families. We seek to ensure the patient point of view is considered by policy makers. We are writing to comment on the Agency’s List of Proposed 2017 Essential Health Benefits (EHB) Benchmark Plans. States have four options for [...]

Letter to Oregon Insurance Commissioner Emphasizes Importance of Private Insurance

2020-09-24T19:36:14+00:00September 16th, 2015|Categories: Article, Charitable Premium Assistance, Comment Letter, Improve Access to Care, Promote Financial Security, State Advocacy|Tags: |

Regence and Moda, two private insurance plans in Oregon, recently made changes to their 2016 plans that would negatively affect ESRD patients. Specifically, after three months of coverage, any out-of-pocket payments patients make for dialysis treatment will no longer count towards their out-of-pocket maximums. This appears to be an effort to pressure dialysis patients to drop their private coverage and enroll in Medicare. DPC’s letter to the Oregon Insurance Commissioner calls attention to this discriminatory move. Medicare plans do not include an out-of-pocket maximum amount, while most private insurance plans do. Statistics also show that patients with Medicare plans are [...]

Response Memo: FAQs Regarding Medicare and the Health Insurance Marketplace

2020-03-21T20:46:10+00:00September 24th, 2014|Categories: Comment Letter, Promote Financial Security|Tags: |

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 [...]

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

2020-09-24T19:58:03+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 [...]

For New Kidney Failure Patients Under 65: Is Medicare or an Exchange Plan the Better Insurance Option?

2020-03-21T20:46:58+00:00January 13th, 2014|Categories: Medicaid|Tags: |

Chronic Kidney Disease (CKD) patients who progress to end-stage renal disease (ESRD) before the age of 65 now have a new health insurance option—exchange health plans under the Affordable Care Act (ACA). Non-elderly patients who do not have, or will not be continuing, employer-sponsored insurance may be better off in an exchange plan depending on their financial circumstances. The reason for this is that the Affordable Care Act is more generous than Medicare in providing extra financial assistance to low-income individuals. Medicare Programs for Low-Income Patients Patient advocates have never considered Medicare to be a particularly generous health benefit, because it [...]

DPC Encourages Coverage of Renal Dialysis in Exchange Plans

2020-03-21T20:46:58+00:00January 6th, 2014|Categories: Comment Letter, Promote Financial Security|Tags: |

Hon. Marilyn Tavenner, Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Ave, SW Washington, D.C. 20201 Re: Coverage of Renal Dialysis in Exchange Plans Dear Administrator Tavenner: Dialysis Patient Citizens, America’s largest patient-led organization representing dialysis patients, is comprised of more than 26,000 dialysis and pre-dialysis patients and their families. We seek to ensure the patient point of view is considered by policy makers. We are writing to express our concerns about language we found in a spot-check of exchange plan documents that appears to permit disenrollment of patients [...]

Giving Tuesday: What Can We as Dialysis Patients Give?

2020-03-21T20:46:58+00:00December 6th, 2013|Categories: Immunosuppressive Drug Coverage, Patient's Voice, What is Kidney Disease?|Tags: |

By James Myers, DPC Patient Ambassador On the website for the Polycystic Kidney Foundation, there is an announcement about Giving Tuesday, December 3rd, 2013. It says you can give one of three ways: your voice, your time or your dollars. As a dialysis patient, I don’t know about you, but I don’t have any money. But two things that I have a lot of are voice and time, and I am more than happy to lend those to the cause of defeating PKD. I can honestly say that having an invisible fatal illness has colored every decision that I have [...]

Health Insurance Marketplaces Under Affordable Care Act Are Open For Business: What Does It Mean For Kidney Patients?

2020-03-21T20:47:20+00:00October 10th, 2013|Categories: Article, Promote Financial Security|Tags: |

On October 1, online health insurance exchanges went live. Here's what dialysis patients should know about the Affordable Care Act (also known as ACA or "Obamacare"): Health insurance sold in the ACA exchanges is for people who do not (or will not after January 1) have health insurance provided by Medicare or an employer-sponsored health plan. Kidney patients who have received a transplant and whose Medicare coverage has ended/will end soon will want to explore receiving coverage through an ACA exchange plan. Pre-existing conditions will not be a barrier to purchasing an exchange plan. DPC staff is researching whether, for [...]

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