Statement from LaVarne A. Burton on CMS Request for Information


ROCKVILLE, Maryland (August 18, 2016) -- In response to media inquiries about the Centers for Medicare & Medicaid Services request for information issue today, American Kidney Fund President and Chief Executive Officer LaVarne A. Burton issued the following statement:

We look forward to commenting to CMS on this important issue that affects so many patients, especially low-income patients with chronic illnesses.

We have always operated our Health Insurance Premium Program (HIPP) with the highest integrity, ensuring that patients have access to the insurance coverage that they choose to best meet their needs.

We vigorously defend HIPP from inappropriate use or fraud and abuse—some of the nation’s most vulnerable patients depend on our help to access the health care they need to stay alive. We have in place safeguards that we have proposed to the federal government to help ensure that bona fide charitable organizations can continue to help patients in need.

AKF provides help to patients solely on the basis of their financial need. We carefully review each applicant’s financial status and require that they meet specific income-to-expense criteria in order to qualify for our help. Under our assistance program, patients choose their health insurance coverage with no input from AKF—we are not involved in helping patients find insurance nor do we provide patients with advice on which insurance plan(s) to choose. Patients may change their health insurance coverage—and their provider—at any time, and AKF will continue to help them.

Let’s not lose sight of the critical fact that end-stage renal disease (ESRD, or kidney failure) patients have as much right under the law as anyone to access ACA plans. For some, these plans may provide more comprehensive coverage for the full range of medical care they need, including dialysis. For others, Medicare (with Medigap if available to them) or Medicaid may indeed be the best choice. What’s important is that the patient has the choice. Insurers are actively working to take this choice away from low-income patients with chronic illnesses who need charitable assistance to pay their premiums.

We help people with all types of insurance—Medicare Part B. Medigap, commercial, COBRA, and employer group health. The majority—more than 60 percent—receive our help to afford Medicare Part B and/or Medigap premiums. A small minority—about 6,400 patients—receive grants to pay for plans through the insurance marketplace.

Clearly there are fixes that need to be made to the Affordable Care Act but blocking patients’ legitimate right to access these plans—as some of the nation’s largest health insurers are trying to do—is not the answer.