U.S. judge blocks rule on financial assistance for dialysis patients

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By Brendan Pierson

<span class="articleLocation”>A U.S. judge on Thursday put on hold a new
federal rule that dialysis providers have said would prevent
dialysis patients from using charitable assistance to buy
private health insurance.

U.S. District Judge Amos Mazzant in Sherman, Texas stopped
the rule from taking effect Friday as planned. The decision is a
victory for dialysis providers Fresenius Medical Care,
DaVita Inc and U.S. Renal Care Inc, which filed a
lawsuit to block the rule last week.

The order is temporary, preserving the status quo while
Mazzant considers the merits of the lawsuit. Mazzant said the
companies had shown a reasonable probability that they would
succeed.

The rule, announced by the U.S. Department of Health and
Human Services on Dec. 14, would require dialysis providers to
disclose to insurers any charitable assistance their patients
are receiving for their care. The providers said insurers would
use that information to refuse coverage to their patients.

Because of the high cost of dialysis, which treats end-stage
kidney disease, many patients receive financial assistance from
charities, most prominently the American Kidney Fund.

Fresenius, DaVita and U.S. Renal Care all donate to AKF,
according to their lawsuit. Fresenius and DaVita both revealed
last week that they had received subpoenas from federal
prosecutors about their ties to the organization.

In announcing its rule, HHS said it believed financial
assistance was being used to steer patients eligible for
Medicare or Medicaid to sign up instead for private insurance on
the federal Affordable Care Act’s marketplaces, which pays
providers more.

Such steering could harm patients by making it harder for
them to get kidney transplants, the ideal treatment in many
cases, HHS said. Charitable non-profits like AKF do not pay for
transplants or post-transplant care, the agency said.

The agency also said steering could hinder the functioning
of the ACA’s marketplaces.

But the dialysis companies said in their lawsuit that many
patients prefer private insurance because it provides better
coverage, and that the new rule would let insurers discriminate
against them.

They said HHS’s true motive was not to protect patients, but
to entice insurers to stay on the ACA exchanges, which some have
fled due to rising costs.

The companies said HHS violated federal law by rushing the
rule without a required public notice and comment period so it
would take effect before Republican President-elect Donald
Trump, who has promised to repeal the ACA, takes office.



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