DaVita, Fresenius Medical Care: State Budget Bill Could Threaten Patient Access to Dialysis Care for More than 3,765 Minnesotans

Legislation Disproportionately Cuts Vital Medicaid Funding for Patients with Kidney Failure

ST. PAUL, Minn., June 24, 2011 /PRNewswire-USNewswire/ -- The Minnesota kidney care community expressed concern today over the Health and Human Services (HHS) omnibus budget bill (Senate File 760), which would significantly impact Minnesota dialysis patients' access to care, as well as vital health care jobs. SF 760 would cut Medicaid reimbursement to providers, including dialysis facilities, by eliminating Medicaid coverage of Medicare Part B coinsurance for Minnesotans eligible for both Medicare and Medicaid (so-called "dual eligible" patients).  Although Governor Mark Dayton vetoed SF 760, typically previously vetoed bills are hastily amended in Special Session.  Kidney dialysis providers are working in coordination with many lawmakers who are equally as concerned about this provision and its effect on patients to ensure that it is excluded from the HHS omnibus budget bill when, at some point, the Legislature is convened for passing an over-all state budget.

Although this provision of SF 760 has been estimated to save the state of Minnesota approximately $45 million over two years, industry analysis indicates that dialysis providers would bear $5.2 million of the total cost savings realized through this change. Specifically, these Medicaid cuts would negatively impact many Minnesota facilities' ability to preserve their necessary staffing levels and cover direct treatment costs, which would inevitably result in facility closures and access to care problems. Thousands of Minnesota patients with kidney failure depend on dialysis care for their survival and should not have to shoulder the burden of such a disproportionate cut in funding.

The Medicare benefit for end-stage-renal-disease (ESRD) – also known as "kidney failure" – is the only entitlement within the program guaranteed regardless of age; thereby, Medicare is most often the primary payor and Medicaid is the secondary payor. Because of this, 33 percent of dialysis provider reimbursement from Minnesota Medicaid comes from Medicaid secondary payments as part of a "dual-eligible" reimbursement structure. The high percentage of dually-eligible dialysis patients combined with the needed frequency of dialysis therapy (often thrice weekly for each patient), means that a reimbursement cut of this magnitude would seriously impact facilities' ability to continue providing care to their patients.

If this unsustainable cut were to go into effect, many dialysis facilities across the state would begin to operating at a significant loss.  If closures occur, some patients could be forced to travel to another town or city three times a week in order to receive treatment, which negatively affects their quality of life and their ability to maintain jobs and take care of their families. Furthermore, travel costs could prove to be very costly for many patients. Access to care issues for patients frequently result in increased hospitalizations and greater reliance on emergent care, which in turn places an even greater burden on the state's health care system.  

Finally, not only is a reduction in Medicaid reimbursement for dialysis harmful for patients and costly to the State, it also has a direct impact on local economies. Cuts to reimbursement will reduce local job opportunities and hinder dialysis providers' ability to expand their businesses and services in order to meet the growing demands of the increasing number of Minnesota dialysis patients.

On behalf of the Minnesota dialysis community, we are extremely appreciative of the support we have received so far from lawmakers in both the House of Representatives and the Senate as we continue efforts to protect this vital funding to ensure patients' access to care. We also urge other lawmakers to reconsider their proposal to cut Medicaid reimbursement for dialysis providers and reevaluate the tremendous impact a cut of this nature could have on the patients who rely on this treatment for survival.

SOURCE DaVita, Fresenius Medical Care