Sample Comment Letter to Medicare
Dear Medicare,
I am a (patient, family member, staff member, doctor, board member, volunteer). I care about the future of dialysis for our patients.
Thank you for selecting the treatment as the unit of payment. This will help dialysis patients get more, not less, treatment. It is good that you allow payment for more than three hemodialysis treatments a week if needed.
The lab rule does not make sense since kidney doctors often serve as primary care doctors and order lab tests not related to dialysis care. Don’t make the dialysis unit be responsible for paying for all of the lab tests ordered by the nephrologist. Please adopt a list of lab tests for dialysis and provide enough funding for the dialysis unit, which has to pay a laboratory to do the testing because it does not own a lab.
Quality might be improved if oral drugs for bone disease are included in the bundle. Please wait a few years to put these drugs in the bundle, until you have better information regarding the costs the dialysis unit will have to pay for these expensive medications. Make sure there is enough funding to cover costs.
Every patient deserves the option of home dialysis. They must learn how to do self-treatment safely before they go home and whenever they need retraining. Please provide a payment adjustment for the additional costs of home training. Without this separate payment, dialysis units will be less likely to invest in the up-front costs of home training.
Two for-profit companies provide the majority of dialysis treatments in the U.S. I believe that all other dialysis units are “Low Volume” since they care for less than 5 percent of Medicare dialysis patients and do not have the cost efficiencies of being very large. Please help small business in America. I ask that you apply the low volume payment adjustment as required by law to treatments at these small dialysis organizations who have higher costs. Help all providers survive the bundle transition so patients have choices for care.
Thank you.