Policy and Politics News

When social workers earn their Master’s degree, at least one thing is very clear: they have learned about the interplay of bio-psychosocial forces active in the life of every human being, and that these forces shape behavior.

While the dialysis treatment hasn’t changed significantly in the last few years, how the treatment is provided is undergoing transformation. Medicare, the primary payer, is demanding adherence to quality measures. Integrated care is becoming a new model. And the roles of the dialysis team are changing as a result.

Biosimilar drug makers are not required to share their applications and manufacturing processes with the biologics company whose product they are copying, the U.S. Food and Drug Administration says.

Medicare physicians will still get their regular paycheck this week despite a law that was supposed to trigger a 21% cut in wages on April 1.

BALTIMORE—It’s so close, Rob Blaser can almost taste it.

BALTIMORE––If you accept payments from manufacturers or pharmaceutical companies, that information will be shared with the public, thanks to the Sunshine Act. The law was built into the Patient Protection and Affordable Care Act that was released in 2010. It is part of a broader trend toward payers wanting to see more transparency of the interaction between physicians and industry. It follows the release of Medicare claims data showing how much Medicare pays physicians for various services.

A new report explains why the scores from Centers for Medicare & Medicaid Services' star rating system for dialysis facilities should be adjusted to account for underlying community characteristics. The report was written by the policy adviser, Alex Brill, of the law firm Hooper, Lundy & Bookman, which provides public policy and government relations services to Dialysis Clinics, Inc. and the Nonprofit Kidney Care Alliance (NKCA). Members of NKCA include Centers for Dialysis Care, DCI, Independent Dialysis Foundation, Northwest Kidney Centers, and The Rogosin Institute. NKCA provided financial support for the preparation of the report.

The Office of Inspector General of the U.S. Department of Health and Human Services issued a subpoena on March 13 to JSA HealthCare, a subsidiary of the HealthCare Partners division of DaVita HealthCare Partners. DaVita said an attorney with the Civil Division of the United States Department of Justice in Washington, D.C., advised them that the subpoena relates to an ongoing civil investigation concerning Humana’s and its service providers’ risk adjustment practices and data, including identification and verification of patient diagnoses and factors used in making the diagnoses.

There is no doubt that nephrology practice in the United States has been forever transformed by changes in the last decade. Doctors and practice managers have had to adapt to regulatory and legislative changes, market shifts and technological developments. We are constantly adjusting our business models in order to remain in compliance with government mandates and meet the changing needs of our business partners, all while continuing to provide low cost, high quality patient care.

States’ decisions to expand Medicaid or not expand Medicaid have mostly been made based on political support or opposition of the Affordable Care Act (ACA). This year with some states having new Governors and political parties as the majority, we are already seeing some flipping of states’ decisions on Medicaid expansion.