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Court Temporarily Blocks Rule to Prevent Charitable Funds for Dialysis Care

A federal judge blocked a final rule promulgated by the Centers for Medicare & Medicaid Services (CMS) that would have prevented patients with end-stage renal disease (ESRD) from receiving charitable contributions to pay for private health coverage.

The CMS rule, announced in December, would require kidney dialysis providers to disclose to insurance companies any charitable contributions end-stage renal disease (ESRD) patients receive to pay for care. Generally, insurance companies refuse to pay claims if a third-party payment is involved.

The rule would steer ESRD patients to Medicare or Medicaid for treatment. Patients who received financial assistance from charities such as the American Kidney Fund may use the funds to purchase private insurance from the Affordable Care Act exchanges instead of Medicare or Medicaid, according to a report from Reuters.

Dialysis providers Fresenius Medical Care, DaVita Inc., and U.S. Renal Care Inc., filed a lawsuit in federal court to block the rule on behalf of their patients, stating that patients often prefer private insurance options and the CMS rule may let insurers discriminate against them. CMS countered that the providers had a conflict of interest in recommending the ACA plans and that the right choice for the provider could be the wrong choice for the patient.

The judge agreed with the dialysis providers and granted a preliminary injunction, blocking implementation of the CMS rule until he can more fully review the merits of the case.

Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.