Is Medicare still only covering 3x a week dialsyis? How are centers that offer daily home hemo getting around this? What would it take to get Medicare on board with daily home hemo dialysis?
John L
Medicare routinely reimburses for 3 treatments a week. However, with medical justification Medicare will pay for more treatments. Your doctor has to review your health to see if any conditions that you have warrant writing a medical justification letter to the Medicare fiscal intermediary (the insurance company that pays Medicare claims for dialysis).
At this point, Medicare is waiting for the results of a clinical trial that is going to compare daily and nocturnal dialysis with three times a week dialysis. We expect a bill to be introduced in Congress soon (I hope) that will (if passed) direct Medicare to develop a methodology to pay for more treatments a week. I’m not sure how open legislators will be to this in the fiscal climate in Washington, DC; however, having patients call and write their legislators once the bill(s) are introduce is the best way we have to influence this legislation. We will announce on our home page, on this message board, and on Home Dialysis Central’s Legislative Action Center when the bill is introduced and encourage everyone – patients, families, friends professionals to support it. Remember, you can do this easily through the Action Center which will identify your legislators for you and give you sample wording that you can personalize.