Archive for December, 2013

Consent to Release

Thursday, December 12, 2013 | By Scott | No Comments

The ESRD Network created this Consent to Release form for a dialysis patient who was having difficulty with her treatment. It clearly states that she can not have any information that was prior to their involvement, and did nothing for her.
It also states that they can contact her or me to discuss issues.  If patients read the actual form, it has no conditions and clearly states that the Advocate is the one that they talk to and the Advocate relays the information to the patient

$250,000 fine for each HIPPA violation

Wednesday, December 11, 2013 | By Scott | No Comments

If you believe that a covered entity or business associate violated your (or someone else’s) health information privacy rights or committed another violation of the Privacy, Security or Breach Notification Rules, you may file a complaint with the Office of Civil Rights (OCR). OCR can investigate complaints against covered entities and their business associates.

If you feel a health care provider, or state or local government agency, has discriminated against you (or someone else) based on race, national origin, disability, or age, you may file a civil rights complaint. OCR can also investigate disability-based discrimination complaints against programs operated by HHS. Under certain statutes and regulations, OCR also has limited authority to investigate complaints of discrimination based on sex and religion. If you believe your health care provider conscience protection rights have been violated, you may file a complaint with OCR.

For more information about the Civil Rights Laws and Regulations OCR enforces, please review their Understanding Civil Rights section or look at their Frequently Asked Question (FAQs).

The Case Resolution Manual for Civil Rights Investigations (CRM) provides OCR staff and managers with the procedures and strategies designed to promptly and effectively evaluate, investigate, and resolve complaints and compliance reviews, and to enforce violation findings where warranted.

COMPLAINT REQUIREMENTS – Your complaint must:

  1. Be filed in writing, either on paper or electronically via the OCR Complaint Portal, by mail, fax, or e-mail;
  2. Name the health care or social service provider involved, and describe the acts or omissions, you believed violated the civil rights laws or regulations; and
  3. Be filed within 180 days of when you knew that the act or omission complained of occurred. OCR may extend the 180-day period if you can show “good cause.”

Download HIPPA Complaint Form

Designation of a Representative

Wednesday, December 11, 2013 | By Scott | No Comments

If a dialysis patient has a complaint or grievance, and needs assistance from Dialysis Advocates in mediating your situation, you will need to fill out a DESIGNATION OF A REPRESENTATIVE form and designate Arlene Muller-Tinker of Dialysis Advocates as your representative and advocate so the clinic or organization can share your records with her and possibly the appointed council.

Download and view the Designation of a Representative form

Medicare payment cuts is a victory for Dialysis Patients

Wednesday, December 4, 2013 | By Scott | No Comments

This is a victory for dialysis patients. Medicare pays for healthcare and it appears to be squeezing the buffalo off the nickel. If Davita holds true to their statement of pulling away from the inner cities and rural areas. That should be a blessing, the patients will go back to their individual Nephrologist, where big non-profit companies don’t want to buy them, and dialysis patient healthcare can only improve.  Nephrologists will be accountable for the patient care and keep factual statistics, a Nephrologist will remain the doctor, not become a sales agent. Patients will not be without dialysis, Nephrologist cannot dump or blacklist his patients legally. Plus these Nephrologist will be accountable for their units, and not have big non-profits protecting them. 

Arlene Mullin-Tinker
Dialysis Advocates LLC

View letters sent to the Centers for Medicare & Medicaid Services/Department of Health & Human Services, House Ways & Means Committee, and the Senate Finance Committee.  Dialysis Advocates and other patient rights organization were a big part of influencing the ruling.

CMS Letter

House Ways & Means Committee Letter 11-22-13

Senate Finance Committee Letter

As expected, and in response to a congressional directive from the American Taxpayer Relief Act, Centers for Medicare & Medicaid Services Department of Health & Human Services (CMS) made a 3.3% cut in payments for dialysis facilities for 2014 to account for reduced drug utilization.  Rather than implementing the full 12% reduction as proposed by the agency this summer, CMS instead chose to phase in the cuts over time.  The 2014 reduction is 27% of the total amount to be cut over the next 3-4 years.

According to federal law, dialysis facilities are entitled to inflationary updates and other fee increases each year to account for, among other items, the increases in the costs for operating a facility and providing the services.  For 2014, CMS calculated this to be 2.8%  When combined with other existing components of the payment formula, the net result is a slight decrease in payments to facilities.  CMS also noted in the rule that it expected the 2015 cut to the drug component would be largely offset by these adjustments  again, resulting in another flat payment.  CMS intends to complete the full 12% cut by 2016 or 2017.

Therefore, the impact of the CMS rule is that rather than getting payment increases each year, dialysis centers will receive flat funding at least for the next two years; this is a reduction in Medicare spending.  Da Vita has already publicly expressed its concerns with the CMS rule and has pledged to fight these reductions in Congress and with the agency in the weeks and months ahead. Also, by increasing payments for home dialysis training, CMS likely provided longer term incentives to shift care to the home and away from these dialysis centers.

Download the entire Patient Rights Watch Ruling.

CMS ESRD 2014 Payment Final Rule