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 [...]
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. [...]
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
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 [...]
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 [...]
By Megan Hashbarger, Vice President of Government Relations Earlier this year, The Jack Reynolds Memorial Medigap Expansion Act (H.R. 1676) was reintroduced by Congresswoman Cynthia Axne (D-IA-03) to ensure all End Stage Renal Disease (ESRD) patients have access to Medigap. This Congress, we were very pleased she was joined by Congresswoman Jaime Herrera Beutler (R-WA-03) in leading this effort. Ensuring all ESRD patients have access to Medigap is extremely important to help patients cover the high costs of care and to improve their access to transplantation. Medigap policies are standardized, private insurance policies that cover costs not covered by Medicare, such [...]
The Centers for Medicare & Medicaid Services (CMS) issued a new rule on hospital price transparency that went into effect January 1, 2021. Under a section of the Public Health Service Act (PHSA), hospitals are required to publish a list of standard charges each year. Originally, hospitals could fill this requirement just by publishing their chargemaster list (a comprehensive list of all products, procedures, and services provided by a hospital) online; now, however, hospitals are told exactly what they are required to publish, and how to publish it, in order to comply with the PHSA. Hospitals must publish the following five [...]
Between now and December 7, dialysis patients are, for the first time, able to choose a Medicare Advantage plan for their coverage. Medicare Advantage is an alternative to traditional Medicare run by private insurance companies. To help kidney patients explore their options, Dialysis Patient Citizens has established Dialysis Plan Choice, an online tool designed in collaboration with Consumers’ Checkbook for dialysis patients to quickly and easily compare their current Medicare Fee-For-Service plan with the options available to them through Medicare Advantage. DialysisPlanChoice.org helps patients and caregivers more easily understand what plans are available to them, the costs are associated with those plans, and, most importantly, which plans [...]
Practical Tips to Assist Beneficiaries in Determining How to Choose Between Traditional Medicare and Medicare Advantage
This webinar will discuss: 1) Medicare basics, 2) The pros and cons of choosing Medicare Advantage as your Medicare coverage option and 3) Particular considerations for people with ERSD.
Emergency grants can help cover costs for transportation, medication, rent and food when someone is sick. This one-page guide will help you better understand the submission process with a summary of searching, preparing, applying and tracking grants. Included is a list of documents you may be asked to submit with your grant request. Reach out to your social worker if you need help. Check out the guide.