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December 20, 2016 at 08:39 AM
Kidney dialysis centers might be keeping some patients from getting desperately needed kidney transplants by pushing them into ordinary individual major medical coverage.
Officials at the Centers for Medicare & Medicaid Services (CMS) include that allegation in an explanation of its reasons for adding new disclosure requirements for kidney dialysis patients who are getting help from the facilities with arranging and paying for the health coverage.
Related: Feds ask insurers about enrollee steering
CMS has established an emergency regulation that requires facilities to tell patients about the possible effects, including costs and transplant implications, of switching plans. The regulation requires the facilities to tell ACA exchange plan issuers when they are helping consumers pay the premiums.
An exchange plan issuer can choose whether to accept third-party payments, CMS says.
The regulations take effect on Jan. 13, 2017.
Kidney dialysis helps people with severe kidney failure survive. CMS officials estimate that 6,737 U.S. dialysis facilities serve about 495,000 people with severe kidney failure.
Medicare covers dialysis for patients who need it and have no other coverage. But the ACA now requires issuers of private medical coverage to offer coverage for all people, including those with kidney failure, for the same standard rates. Some patients qualify for Medicaid coverage instead, and some prefer private exchange plan coverage to Medicare coverage.
