Medicare ESRD Network Is Still At It – They’re Supposed to Help

Monday, January 13, 2014 | By Scott | No Comments

If you want to get a headache, read through the official
Medicare ESRD Network Organizations Chapter 7 – ESRD Complaints and Grievances
here is a copy.

A couple of highlights are below. You may want to consult a lawyer to guide you through this legalize document with cross references that no normal reader, let alone someone who is distress from poor and sometimes humiliating treatment, can truly understand. Will someone in the ESRD please translate this document so it is useful to anyone seeking help!?

It is the responsibility of the Medicare ESRD Network to assure that an impartial review of grievances by Network staff and the MRB occurs without conflict of interest.

But we’ve seen so many instances where the ESRD is creating documents and forms to protect their interests.

Is this guidance or a roadmap for confusion?

Is this guidance or a roadmap for confusion?

The Network shall assume a proactive role in the prevention, facilitation, and resolution of complaints and grievances, including implementing educational programs that will assist facility staff in handling difficult situations.

Why doesn’t the Medicare ESRD Network implement programs to dismiss dialysis providers who practice unethical procedures?

The Network advises anonymous complainants or grievants that their complaints/grievances will be investigated but the Network will be unable to report back to them without their name and address.

So with the fear of blacklisting or undue retribution, if it is anonymous, how do we know any action has been taken?

170 – Personal Representative
A personal representative is an individual designated by a court of competent jurisdiction or by the beneficiary, as evidenced by a document signed by such beneficiary, to act on his/her behalf. An individual/patient/beneficiary may designate whomever he/she chooses as his/her personal representative by executing a Power of Attorney, a Durable Power of Attorney, or a witnessed, signed, and dated proxy statement. The patient representative may act for the person they represent in any capacity that is authorized. The personal representative can be authorized to conduct a single transaction or to assume ongoing responsibility for an identified purpose such as a financial transaction(s), healthcare decision(s), ….


180 – Conflict of Interest
The Network ensures that a conflict of interest or potential conflict of interest does not exist among members of a complaint/grievance committee, a MRB committee, or a board of directors handling a grievance. Any individual who has direct involvement with the complainant/grievant or the provider under investigation, whether it is a financial, professional or personal relationship, should be excluded from participation in the investigation and resolution of the complaint/grievance.

See Above!

If you really want to see the complete document, download the entire document, good luck.

Medicare ESRD Network Organizations, Chapter 7 –ESRD Complaints and Grievances

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