Kidney Patient Organizations Urge Super Committee to Enact Policies to Reduce Federal Spending While Increasing Patient Access to Care

Oct 26, 2011, 12:37 ET from Dialysis Patient Citizens (DPC)

Urge the Committee to Ensure Kidney Failure Patients Covered Under the New Health Insurance Exchanges Will Have Same Choices as Patients Outside Exchanges

WASHINGTON, Oct. 26, 2011 /PRNewswire-USNewswire/ -- In a letter to members of the Joint Select Committee on Deficit Reduction (Super Committee), the nation's leading kidney disease patient advocacy organizations urged the Super Committee to implement policy changes that would preserve health care coverage and access to care for kidney patients, while reducing Medicare spending.

The October 3 letter from the American Kidney Fund (AKF), Dialysis Patient Citizens (DPC), the National Kidney Foundation (NKF) and Renal Support Network (RSN) calls on the Super Committee to enact coverage policy changes related to the new health insurance exchanges that would ensure uniformity in treatment and choice for all end-stage renal disease (ESRD) patients. The policy suggestions outlined in the letter also have strong support from the broader kidney community.  

In the letter, the patient coalition urged the Super Committee to ensure parity in ESRD patients' coverage inside and outside of the new health insurance exchanges, specifically as it pertains to application of the Medicare Secondary Payer (MSP) law.  Currently, Medicare is the secondary payer for individuals with private coverage who develop kidney failure, and after the first 30 months Medicare becomes the primary payer for these patients.  Unless MSP is applied to plans in the new exchanges, kidney patients will automatically shift to Medicare coverage if they use an exchange to purchase private coverage, reducing patient choice and increasing the burden on Medicare.

"Unless it is clarified that MSP law applies to plans available through the exchanges, patients will automatically lose their opportunity to obtain coverage through the health insurance exchanges once they are diagnosed with ESRD," state the patient groups. "At the same time, Medicare will become the primary payer of coverage for the patients...  From the patient's perspective, an abrupt shift in coverage could limit access to benefits and increase out-of-pocket expenses."

The patient organizations also stated strong support for allowing individuals who satisfy established income requirements and who develop kidney failure to qualify for premium credits and cost-sharing subsidies through an exchange, even though their kidney failure makes them eligible to enroll in Medicare.  This will make private coverage attainable for more Americans, further reducing the number of persons with kidney disease who rely on Medicare for coverage.

Rather than implementing across-the-board or other Medicare cuts to the ESRD benefit, which would be particularly harmful to patient care due to the dialysis population's large percentage of Medicare-covered patients and the considerable funding reductions already made to the ESRD program under its new prospective payment system (PPS), the organizations noted that the kidney community's proposals would create equitable policy for patients that would also lead to savings.

As the letter concludes, "By creating consistent policy for people with kidney failure inside and outside health insurance exchanges, the Super Committee can reduce the number of patients reliant on Medicare for their health needs… These common sense, cost-effective policies will ensure equal treatment and access to choice for Americans who develop kidney failure, while working to improve our country's long-term economic outlook."  

The full letter can be found here:

SOURCE Dialysis Patient Citizens (DPC)