AKF comments on proposed ACA rule concerning nondiscrimination in health care

In September 2015 the Office of Civil Rights at the Department of Health and Human Services (HHS) released a notice of proposed rulemaking entitled Nondiscrimination in Health Programs and Activities. The rule explains how HHS would implement Section 1557 of the Affordable Care Act (ACA), which prohibits the discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. We commented on the proposed rule and explained the discrimination that dialysis patients face by some insurance companies accepting third-party payments by the Ryan White HIV/AIDS program on behalf of people with HIV or AIDS, but rejecting third-party payments by AKF on behalf of people with ESRD on dialysis.

AKF comments on proposed benefits and payment parameters for qualified health plans in 2017

In December 2015 HHS issued a proposed rule entitled Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017. The rule provided another opportunity for us to urge HHS to require that health insurance companies accept our health insurance premium payments directly on behalf of the dialysis patients we serve. The proposed rule announced that HHS was considering requiring health insurance companies to accept third-party payments from nonprofit charitable organizations, but instituting certain “guardrails.” One proposed guardrail was only allowing premium payments for individuals who are not eligible for other minimal essential coverage (MEC). Because Medicare is an MEC, and because most patients with end-stage renal disease (ESRD) on dialysis are eligible for Medicare, we have serious concerns that dialysis patients would not be protected because of this guardrail. In our comments, we stressed the difference between eligibility for an MEC and enrollment in an MEC. We emphasized that ESRD patients who are eligible for Medicare deserve the choice to stay on their private insurance for as long as the law allows and should not be forced to immediately go onto Medicare.