Hello all. I have learned that the dialysis companies will pay for (provide) phos binders to dialysis pts. Anyone heard much about this and has a date been mentioned when this will take effect ? Also, what additional medications will be included
in the “bundle”.
Thank you !
A law called the Medicare Improvements for Patients and Providers Act required CMS to establish a “bundle” of services for dialysis facilities to include a number of things that dialysis clinics have been are allowed to bill separately including drugs given by dialysis clinics by injection or IV as well as their the oral version of those drugs. CMS published a “proposed rule” that recommended expanding that was required by the law to include other drugs that dialysis clinics hadn’t provided before and that patients were getting under Part D, including phosphate binders and Sensipar. The proposed reimbursement for all these drugs whether patients take them or not was suggested to be $14/treatment. Dialysis providers, kidney professionals and even kidney patients have commented on the proposed bundle and most think it would be a bad idea to expand what the law requires to phosphate binders and Sensipar inn part because 1) the law doesn’t require this; 2) the amount Medicare proposes to reimburse is lower than their cost and 3) patients who don’t take these drugs will be charged the Medicare coinsurance (20%) for drugs they’re not taking. Bundling is supposed to start 1/1/11, but the final rule has not been published yet so no one knows if phosphate binders will stay in the bundle or not at this point. Stay tuned as when we find out more, we’ll let everyone know.