I found out something very interesting and disturbing yesterday.
A man in our building is on hemo in center with another center in our area (Freni). He wants to do home dialysis (Nxstage), but can’t. The VA has a contract with the center that does not do Nxstage and they will not allow him to (pay) to go to our center to learn Nxstage. Not only that but they are in the process of setting up a dialysis unit at the VA hospital in Albany and all their people will have to go there.
Anyone have any thoughts about this? I do not know if he has other insurance or not.
Pat
Those are good questions Pat - access to healthier options should not be denied to vets because some bureaucratic box wasn’t checked. I know a doc who is very pro home hemo who is associated with the VA I’ll ask her for any info she can share.
This is exactly why there needs to be legislation that says that dialysis patients should have the right to any modality they desire.
Boy you guys are right on top of things.
I just feel bad for him. He is waiting for a transplant but that could take some time.
Every person who dialyses should be able to have a choice of how and when they dialyise.
Pat
Hi Folks
Hi Pat , best to you and Ralph…
Don’t worry Pat, The ESRD network and the NKF and all the othe pt. groups that are out there to help the dialysis consumer . With all sorts of issues like this, that why they exist… All these groups are out there for the person with the disability
I wish this man all the best and to fight the power
bob obrien
[QUOTE=Pat Colongione;16008]I found out something very interesting and disturbing yesterday.
A man in our building is on hemo in center with another center in our area (Freni). He wants to do home dialysis (Nxstage), but can’t. The VA has a contract with the center that does not do Nxstage and they will not allow him to (pay) to go to our center to learn Nxstage. Not only that but they are in the process of setting up a dialysis unit at the VA hospital in Albany and all their people will have to go there.
Anyone have any thoughts about this? I do not know if he has other insurance or not.
Pat[/QUOTE]
I’ll be interested to learn what Bill finds out.
The VA may contract for dialysis services with a limited number of facilities to keep costs under control. The VA does pay for home dialysis according to its manual. The VA may be used to paying for 3 treatments a week, like Medicare. There may need to be more advocacy to get the VA to pay for more frequent treatments. Since the VA pays for inpatient and outpatient care, it should be more interested in the health benefits of more frequent or longer treatments if it saves money on hospital and medication costs like research shows.
You say that the VA has a contract with Fresenius. Currently Fresenius doesn’t have a contract with NxStage. As I understand it, when DaVita bought part of NxStage, there are certain areas of the country (10%) where DaVita is the only dialysis clinic offering the NxStage. This may be contributing to the situation your friend is experiencing.
Veterans are encouraged to sign up for Medicare if they have worked enough to qualify. When someone has VA and Original Medicare, he/she can choose where to go to get dialysis as long as it’s in the U.S… If the patient chooses to go to a facility that is not contracted with the VA, Medicare would pay. If the VA is not paying for treatment, the VA would not have any say about where the patient goes. To have Medicare coverage, the patient would need to pay the Medicare Part B premium (which is a small price to pay compared to what Medicare pays for dialysis). Because Medicare has an outpatient deductible and a 20% coinsurance for each charge, the patient would need to buy a Medigap plan if he/she doesn’t have Medicaid. This would cover 3 and possibly an additional treatment each week if medical justified. The facility could charge the patient for the extra days that Medicare doesn’t cover.
Another option would be for the patient to go to a Fresenius clinic that the VA contracts with if that clinic offers nocturnal home (or even in-center) hemodialysis. Fresenius clinics that offer this treatment typically provide dialysis 3 nights a week. Medicare (and the VA) should pay for the 3 treatments whether they’re done in 3-4 hours a treatment as with conventional dialysis or 7 or longer as in nocturnal dialysis. From patients I’ve heard that doing dialysis 3 nights weekly helps them feel much better than doing 3-4 hours of dialysis 3 times a week.
The Fresenius machine isn’t portable so patients doing nocturnal dialysis at home would need to do in-center dialysis when traveling. More clinics are starting to offer nocturnal in-center dialysis which means that the patient may be able to get the same number of hours of dialysis whether at home or traveling. Also, he/she wouldn’t need to take equipment or supplies along or have them delivered.
As you can see, there are pros and cons to everything.