PD Training "closed" during Baxter fluid shortage

My husband is recently out of the hospital in ESRD, doing HD in clinic via Central catheter. He wants his PD catheter placed, and we want to get trained immediately on PD, because he has no insurance and the ESRD Medicare insurance starting December 24th, will start retroactively the first day of HD (Sept 23) if we get trained in PD within 90 days. His 16 days in hospital, subsequent ER visit to replace the poorly placed central catheter, and current m,w,f HD in clinic will not be covered if we cannot get trained in the next few weeks. Our clinic says trainings are closed due to the Baxter fluid shortage. This is unacceptable. We can still be trained, be signed off by a dr, and wait to start PD when Baxter is providing fluids again. My husband has a right to his insurance, and we need to find a place to train us since our clinic is stonewalling us. Do you have suggestion about how we can obtain training and getting a catheter placed?
Thank you so much.

He should be covered while using the port. Technically he is doing dialysis. Who told you he wasn’t?

There has been a shortage of Baxter PD solution because the only plant in the U.S. that makes PD fluid for Baxter PD machines was damaged in Hurricane Helene. However, it appears from this HHS notice that efforts are underway to resolve this shortage. The Baxter plant has reopened and begun shipping PD fluids and HHS approved importing PD fluids from overseas.
https://www.hhs.gov/about/news/2024/10/18/fact-sheet-hhs-continues-action-increase-access-supply-iv-fluids-hurricane-helene.html

If your husband’s clinic and nephrologist haven’t seen this, it might mean that they can start moving ahead with PD. He will need to have a PD catheter placed and he could do HD until his exit site heals. Talk with the doctor about whether he can get the catheter placed now and start training down the road after the exit site has healed. Medicare will pay for up to 15 days of training for PD, but most people can learn PD much faster, often in a week or so.

As you were probably told, there is a 3-month waiting period for Medicare if someone chooses to do in-center dialysis. However, if his first dialysis treatment was September 23, 2024, he just needs to START home training by December 1, 2024 to get Medicare backdated to September 1 to hopefully cover the medical expenses he had the month dialysis started. Here’s a booklet that describes Medicare coverage for dialysis and transplant. https://www.medicare.gov/publications/10128-medicare-coverage-esrd.pdf.

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There is a 3-month waiting period for Medicare for people with kidney failure. If a patient starts training for home dialysis before the end of that period, Medicare can be backdated to the first of the month dialysis started.

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Thank you, Beth, for making this clear for me. I will go back to my husband’s doctors on Monday and push a little harder for PD catheter placement date, and for the training to begin. I’m being told they can’t train me because of the Baxter fluid shortage. I maintain they can train me anyway because I will understand what’s necessary whether or not the fluids are available.

Another option is to check to see if there is a Fresenius clinic nearby. Fresenius provides dialysis care and makes PD machines and supplies. I don’t believe Fresenius manufacturing was impacted by the hurricane. I found this press release that might be of interest.

6 month waiting period for disability to kick in and 3 months for Medicare to kick in

Call around to different dialysis clinics if your a patient on dialysis they are to put you on a waitlist

The waiting period for SSDI is actually 5 months. The first check is paid in the 6th month. There is a 3-month waiting period for Medicare UNLESS you get a transplant or you start home dialysis training before the end of that 3-month period. In either of those cases, Medicare can be backdated to the month of the transplant or the first day of the month you started dialysis.

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Thank you. I just realized last night that we can do home hemodialysis. He has a Central cath, and I never knew that hhd was an option until last night when I was rereading the CMS guidelines. So I spoke with a nephrologist today and asked her to please speak to the education nurse at DaVita where he does his dialysis, and ask her to contact me. I realize we only have a small window of time here. Unfortunately my husband just went back into the hospital with pneumonia, and a mass in his right lung. So starting training for home dialysis has now got a wrench in it… Three hospitalizations in 37 days… we somehow need to get that training started to get that Medicare backdated.
I reviewed the 2728 form, and tried to explain to the doctor they just need to “start” training, and sign off that they expect we would be able to do it. And that would be enough to have it go through.
I will keep pushing. Thank you again for your support. It means so much right now. :pray: