Medicare should ensure that every dialysis patient can access the dialysis treatment option that is best for his/her health and lifestyle, including home dialysis. In fact, the law requires Medicare to make a concerted effort to increase use of home dialysis.
CMS Issues Annual Rule; HDU Calls on Agency to Fix Training Payment.
The annual proposed ESRD payment rule is out, just prior to last weekend’s Independence Day holiday. While the rule contains many technical modifications and apparently non-substantive clean-up of some definitions, we are dismayed that, again this year, the Centers for Medicare and Medicaid Services (CMS – the agency that oversees Medicare’s dialysis policies) continues to turn its collective back on the problem facing patients who would like to choose home dialysis.
That problem, as we have discussed at length over the years, is Medicare’s inadequate reimbursement for home hemodialysis patient training; it simply doesn’t come close to covering the total incremental cost of providing this essential service. This means there continues to be a disincentive to provide training, making it difficult for patients to learn about and gain access to the potentially life-changing benefits of home hemo.
As a patient group, we must speak clearly and definitively on this issue. Dialysis patients have a right to choose home dialysis and CMS is not following Congress’ directive to ensure that as many patients as can be treated at home should be so treated. This problem won’t be fixed until Medicare fully reimburses providers for the upfront costs associated with patient training. It’s time for patients, providers, and those that care about our community to speak loudly and clearly on this issue.
To that end, HDU is launching a petition urging CMS to update its payment policy to include full reimbursement for HHD training as part of the final rule for 2015. Today, Medicare pays only about $50 per training session toward the costs of having an experienced nurse, social worker and dietitian provide one on one training to new patients, while Medicare’s own data shows the real cost of providing training is about 5 times that or more. Please join us in demanding that CMS fix this problem and do it this year!
You can sign the petition (and we sincerely hope you will) here www.homedialyzorsunited.org/training-petition . We also encourage you to share the petition with family and friends so they can support us on this important issue. You will find icons on the petition page to share the petition through email, Facebook, Twitter, and Google+.
We are doing this because of the stories we hear regularly and consistently from HHD patients, care partners and others who have trouble accessing HHD treatment for themselves (or know someone who has), as well as for those who have experienced the benefits and want to make sure everyone has access.
Many of us in HDU have experienced firsthand the clinical and life benefits of home dialysis and we often say that it has given us back our lives. Now it’s time to pay it forward so others can experience the difference too.
CMS will issue the final 2015 rule later this year, so please don’t wait. Sign the petition now to ask CMS to take a second look at the rule, and make sure the final version – once-and-for-all – includes the complete fix for home dialysis training. We are also asking CMS to establish a target threshold of 10% of patients on HHD. Without goals, we will continue to get nothing but excuses.
The petition will be delivered to CMS near the end of the proposed rule comment period. We will also share the results with Members of Congress to encourage their support as well.
If you are comfortable telling your story – in addition to signing the petition – we encourage you to write a comment supporting home dialysis patient training on the rule’s official comment page at http://www.regulations.gov/#!documentDetail;D=CMS-2014-0092-0002.
Thanks for your time and for your continued support!
HDU Board of Directors