Spring 2023 State Advocacy Update

2024-03-28T20:57:26-04:00June 14th, 2023|Categories: Costs for Treatment, Resources, The Kidney Citizen|

Elizabeth Lively, DPC Eastern Region Advocacy Director Pamela Zielske, DPC Western Region Advocacy Director The 2023 legislative session has been a busy and productive one for DPC’s state advocacy efforts. Bills impacting dialysis patients have been introduced in multiple state legislatures and in most cases have moved quickly through the legislative process. Improving access to Medigap coverage is a top priority for DPC, and we are thrilled that legislation was introduced in multiple states this session to expand Medigap access to patients under the age of 65. Last month, DPC celebrated Governor Glenn Youngkin's (R) signing [...]

Ask the Doctor

2024-03-28T20:57:29-04:00June 14th, 2023|Categories: Costs for Treatment, Dialysis, Hemodialysis, Home Hemodialysis, In-Center Hemodialysis, Kidney Transplant, Medication, The Kidney Citizen|

Velma Scantlebury, MD, DPC Education Center Health Care Consultant 1. Four hours is too long for me to sit in dialysis. Do I have to attend every treatment? Answer: Think of dialysis as being the only way to get the toxins out of your body from the food that you consume everyday - three times a day. When you lose kidney function and are on dialysis, you are usually then only cleansing your body every other day. Those toxins will build up and can cause your body to deteriorate over time. Missing dialysis is harmful to your body. [...]

Supreme Court Erases Kidney Patients’ Insurance Protections

2024-03-28T20:57:47-04:00October 27th, 2022|Categories: Costs for Treatment, The Kidney Citizen, Treatment|

By Megan Hashbarger, DPC Vice President of Government Relations and Jackson Williams, DPC Vice President of Public Policy 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 [...]

Value-Based Health Care & Medicare – Weighing the Pros and Cons

2024-03-28T20:58:03-04:00June 14th, 2022|Categories: Costs for Treatment, eNews, Medication, Treatment|

Value-based care has become a hot topic in the health care industry. The model of paying providers bonuses for better patient health outcomes and penalizing them for poor outcomes may seem like a great idea and one that would encourage a more holistic approach to patient care. Some health care experts have concerns about what this means for people on Medicare Advantage (MA), though; specifically, there may be more focus on costs and less focus on quality. Janice Horowitz, author of Health Your Self, has three primary concerns when it comes to value-based care in MA plans: Restrictions on where you [...]

Medicare Surprise: Drug Plan Prices Touted During Open Enrollment Can Rise Within a Month

2024-03-28T20:58:04-04:00June 6th, 2022|Categories: Costs for Treatment, eNews, Medication|

By Susan Jaffe May 3, 2022 Something strange happened between the time Linda Griffith signed up for a new Medicare prescription drug plan during last fall’s enrollment period and when she tried to fill her first prescription in January. She picked a Humana drug plan for its low prices, with help from her longtime insurance agent and Medicare’s Plan Finder, an online pricing tool for comparing a dizzying array of options. But instead of the $70.09 she expected to pay for her dextroamphetamine, used to treat attention-deficit/hyperactivity disorder, her pharmacist told her she owed $275.90. “I didn’t pick it up because [...]

DPC’s State Advocacy Efforts Flourish with Elevated Voice of DPC Patient Ambassadors

2024-03-28T20:58:09-04:00April 25th, 2022|Categories: Costs for Treatment, Kidney Transplant, The Kidney Citizen, Uncategorized|

Image: Medigap champion Kentucky State Rep. Tom Burch and Elizabeth Lively, DPC Eastern Region Advocacy Director By Kelly Goss, J.D., LL.M., Western Region Advocacy Director and Elizabeth Lively, Eastern Region Advocacy Director, Dialysis Patient Citizens (DPC) It’s been a busy start in 2022 for DPC’s state advocacy efforts. Many states are holding shorter legislative sessions due to the upcoming primary elections, and several bills impacting dialysis patients have been introduced and are moving quickly through the legislative process. Legislation to expand Medigap access has been introduced in Arizona, Kentucky, Louisiana, Maryland, Nebraska, New Jersey, Rhode Island, Vermont, and Wisconsin. Improving access [...]

New “No Surprises Act” Aims to Eliminate Surprise Medical Bills

2024-03-28T20:58:38-04:00January 10th, 2022|Categories: Costs for Treatment, eNews|

On January 1st, a new act known as the No Surprises Act, went into effect to protect people with group and individual health insurance from receiving unexpected out-of-network medical bills. This means that individuals with private health insurance are protected from receiving additional bills for emergency services, services from out-of-network providers at in-network facilities, and out-of-network air ambulance providers. Uninsured or self-pay individuals have new resolution opportunities if they receive a medical bill that is significantly higher than the good faith estimate they were provided, and there is also a new dispute resolution process for payment disputes between plans and providers. [...]

Research Report Finds Minimal costs to enacting Jack Reynolds Memorial Medigap Expansion Act

2024-03-28T20:58:40-04:00December 17th, 2021|Categories: Costs for Treatment, The Kidney Citizen|

By Jackson Williams, DPC Vice President of Public Policy A research report commissioned by DPC has found that passage of the Jack Reynolds Memorial Medigap Expansion Act (H.R. 1676) would add only minimal costs to the federal treasury and to seniors’ Medigap premiums. H.R. 1676  would require insurers to make Medigap plans available to End-Stage Renal Disease (ESRD) patients under the age of 65. The report from Health Management Associates (HMA) calculated the costs associated with changing the law. Under current federal law, insurers are not required to offer Medicare Supplemental Insurance (also called Medigap) plans to patients under 65 years of age. While Medicare pays for roughly 80 [...]

DPC’s New Report Card on Medigap Coverage Helps ESRD Patients Understand their Medicare Supplemental Insurance Options

2024-03-28T20:58:41-04:00December 17th, 2021|Categories: Additional Resources, Costs for Treatment, The Kidney Citizen|

By Kelly Goss, J.D., LL.M., Western Region Advocacy Director If you’re a dialysis patient under age 65 looking to purchase a Medigap plan, DPC’s new interactive Medigap Report Card will help you understand the availability of Medigap coverage in your state. Medicare Supplemental Insurance, or Medigap, is provided by private insurance companies to help Medicare enrollees cover their out-of-pocket “gap” costs – such as copays, coinsurance, and deductibles – not covered by Original Medicare. Providing accessible and affordable Medigap coverage is critical to ensuring patients with End Stage Renal Disease (ESRD) can fully cover the cost of their care, since Medicare [...]

Why DPC Fights To Maintain Private Insurance Coverage for Dialysis

2024-03-28T20:58:45-04:00December 17th, 2021|Categories: Costs for Treatment, Quality of Life, The Kidney Citizen|

By Jackson Williams, DPC Vice President of Public Policy In recent years, private insurance coverage for dialysis patients has come under attack. In 2016, the outgoing Obama Administration issued a regulation that would have prohibited charities like the American Kidney Fund (AKF) from assisting patients with premiums. Several insurers unilaterally refused to accept checks from AKF or eliminated dialysis providers from their networks. Some employers have tried to restrict coverage for dialysis by amending their health plan language. The SEIU labor union promoted legislation and ballot initiatives, most notably in California, to restrict or eliminate insurance coverage for dialysis. DPC has [...]

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