Great News for Medicare Part D Recipients

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) issued rules for Medicare Part D prescription drug plans that required dialysis patients to get prior authorization for their medications. This resulted in delays as some dialysis patients had to wait for authorization before accessing medications to fight infections, nausea, pain, and anxiety among other ailments. This past Friday, after many conversations between CMS leadership, National Kidney Foundation staff, professional volunteers, and other organizations representing kidney professionals and patients, CMS reversed its guidance and is now encouraging Part D plans to change their policies so that patients no longer have delays getting certain medications.

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6 Things You Need to Know about Open Enrollment in the Health Insurance Marketplace

A Bit of Background:
The Health Insurance Marketplace was created with the passage of the Affordable Care Act, making health insurance more accessible and affordable to individuals and small businesses. This law offers many patient protections, such as banning insurers from refusing to cover individuals with a pre-existing health condition or charging them significantly higher premiums, and stopping the practice of life-time and annual caps on health insurance benefits. The law requires every American to have health insurance or pay an additional tax if they do not enroll in a plan. Subsides to lower the cost of monthly premiums are available to individuals with incomes between 138% and 400% of federal poverty level (FPL).  In states that did not expand their Medicaid programs, subsidies are offered for individuals with incomes starting at 100% of FPL.  Subsidies to lower the amount people have to pay out-of-pocket for their healthcare services and medications may also be available depending on your income level and plan*.
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Payment and Treatment for Dialysis Patients: CMS Issues Final Rulings

On Friday, October 31, the Centers for Medicare & Medicaid Services (CMS) issued final regulations regarding payments to dialysis facilities and quality measures dialysis facilities must meet in 2017 and 2018 to avoid facing a penalty.

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Be a Part of NKF’s Kidney Patient Summit

The National Kidney Foundation (NKF) is hosting the 2nd Annual Kidney Patient Summit in Washington, DC, on March 2-3, 2015.  Join us for this special National Kidney Month event as we unite as one voice to tell Congress about the importance of awareness, prevention and treatment of kidney disease!

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Medicare Open Enrollment Season—Know Your Options

Medicare Open Enrollment season is here, and you have from now until December 7th to change your Medicare Part D (prescription drug plan) or Medicare Advantage plan (managed care plan) for 2015.  Research has shown that only 13% of beneficiaries change their Part D plan even when doing so could result in better coverage and lower costs for beneficiaries.  These drug plans change every year, so even if you stay in the same plan, which medications are covered and the cost you have to pay for them may change next year.  Click here to learn more about how to review your Medicare Part D options and why it’s so important.

You can also compare your options for both Medicare Advantage plans and Medicare Part D plans on Medicare’s plan finder website.  Note: if you have end-stage renal disease (ESRD) and are in a Medicare Advantage plan, you may not be able to switch plans unless the plan is offered by the same company you have now.  However, you can choose to go into Medicare fee for service (Part B).  Also, if you have ESRD and are in Medicare Part B, you cannot enroll in Medicare Advantage.  Everyone is eligible to choose and switch among Part D plans.

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FDA Permits Importation of PD Solution

Last month Baxter announced they were experiencing a shortage of their peritoneal dialysis (PD) solutions.  While current patients were able to receive their shipments on time, many experienced disruptions in their normal delivery.  Many new patients were unable to start PD.  The National Kidney Foundation submitted comments to the Food and Drug Administration (FDA), urging the agency to quickly review and determine if Baxter could safely import solutions from its overseas facilities.  While NKF did not act alone in advocating for an expedited solution, we are pleased that efforts were heard and that yesterday evening the FDA announced that it will allow importation of some Dianeal solutions from Baxter’s facility in Ireland.  This is expected to help alleviate the shortage until Baxter is able to ramp up production in the U.S.

While the Dianeal solution manufactured in Ireland is the same solution made in the U.S., there are some differences in the packaging including the connectors and the quantity of solution in each bag.  You can read more about what to look for in Baxter’s letter to patients and learn more about this issue on the FDA’s website.

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Join NKF and Make a Difference

washingtonYou may already follow the National Kidney Foundation (NKF) on Facebook, Instagram or Twitter. Maybe you read our blog posts or visit our website for information. But did you know you can also join NKF and become part of the oldest and largest kidney organization in the country? You’ll join in our shared mission to improve the lives of people affected by kidney disease.

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Meet Ewo Harrell – Winner of Rich Salick Memorial Scholarship

Ewo Harrell moved to Paris, France after graduation from Union College in NY, in hopes to gain experience for a future career in Foreign Service.  But in 2011, less than a year later, Ewo became very sick and French researchers and physicians discovered she had a rare condition called “collapsing glomerulopathy” combined with lupus.  The addition of lupus made the kidney disease aggressive and difficult to treat.  Ewo began hemodialysis treatment indefinitely while recovering from complications from kidney failure.

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NKF Responds to Medicare’s Proposed Changes to Payment and Quality Programs for Dialysis Facilities

Back in July we shared the Centers for Medicare & Medicaid’s (CMS) proposed changes to dialysis payment and quality incentive program.  After gathering input from kidney patients and professionals we issued formal comments to CMS, which included recommendations for revising their proposals to strengthen patients’ access to high quality care.

Our concern about the proposed changes to payment is that rural facilities that already, on average, lose money treating Medicare patients would receive payment cuts.     Dialysis providers are likely to close facilities that continue to lose money, which could cause patients to face greater transportation challenges if they have to commute further for dialysis.  NKF recommended that CMS make changes to the way it pays for dialysis to ensure facilities in rural areas are able to cover the costs of providing the care that is needed to improve the health of their patients.

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NKF Expresses Disappointment Over Dialysis Five-Star Rating Program

CMSThe Centers for Medicare & Medicaid Services (CMS) is planning to implement a new program to help patients and their loved ones better understand the quality of care delivered by dialysis facilities through a five-star rating system. While the National Kidney Foundation (NKF) appreciates the efforts of CMS, we are disappointed by their announcement on September 10, 2014 that it does not plan to make changes to the Dialysis Five-Star Rating Program before rolling it out. Instead, CMS will delay the program launch from October 2014 to January 2015 in order to engage in a patient education effort about the system.

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