CMS Rule Change Protects Insurers at CKD And Dialysis Patients’ Expense



Alice Andors of the American Kidney Fund wrote and said, "Hey Kidney Buzz -- A new rule from Centers for Medicare and Medicaid Services (CMS) is bad news for ESRD patients." Unfortunately, Ms. Andors appears to be absolutely correct. According to reports, CMS released an Interim Final Rule effectively removing Chronic Kidney Disease patients from the insurance decision-making process and leaving insurers to decide whether to provide insurance coverage to the many Chronic Kidney Disease and Dialysis patients who are financially struggling. Immediate action is necessary from the Chronic Kidney Disease Community (patients as well as family members and friends of patients). Sign the below petition in order to prevent thousands of Chronic Kidney Disease patients' insurance policies from being disrupted or worse.

CMS suggested that their goal is to create a more "transparent process" for patients selecting insurance options. However, their Interim Final Rule strips Chronic Kidney Disease and Dialysis patients' protections provided by the Affordable Care Act, and limits charitable assistance for those that find it difficult to afford necessary insurance coverage. Hence, the new rule leaves coverage decisions entirely to the discretion of insurers who have a strong financial incentive to drop these patients from their rolls or refuse to insure them.

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"CMS needs to acknowledge that insurers have financial incentives to deny coverage for expensive patients with pre-existing conditions," said LaVarne A. Burton (President and Chief Executive Officer, American Kidney Fund). Clearly, this would almost certainly include Chronic Kidney Disease patients, especially those on Dialysis. What would patients be left to do if they had to cover massive out-of-pocket co-payments and other costly expenses because insurance companies were able to simply deny them coverage due to unaffordable premiums? 

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What's more incredible is that the rule fails to point out that mid-year disruption in coverage—a real problem for patients—is caused entirely by insurers who elect to terminate coverage for patients who receive charitable assistance. strongly believes that a patient’s need for financial assistance should in no way disqualify him or her from any health insurance plan. CMS should protect ESRD patients in the same way that it protected low-income HIV/AIDS patients in 2014 when insurers tried to exclude them from Marketplace coverage by refusing payments from the Ryan White AIDS Program.

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This rule gets it wrong and puts Chronic Kidney Disease and Dialysis patients at serious risk of not being able to have crucial insurance coverage. If you agree, then sign and share the below petition to help protect Chronic Kidney Disease and Dialysis Patients

Name *
I urge CMS to halt this Interim Final Rule which ultimately helps insurance companies at the expense of Chronic Kidney Disease and Dialysis patients. *

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