Court freezes CMS rule on premium assistance for dialysis patients

A federal judge has temporarily blocked a CMS rule on requiring dialysis companies to disclose all charitable premium assistance they provide to patients.

Dialysis companies Fresenius and DaVita had already won a temporary restraining order in the case. The new ruling extends that indefinitely under the argument CMS and HHS had unlawfully bypassed the public comment period when finalizing the rule.

While the rule doesn’t bar dialysis companies from providing financial help to patients, the disclosure would violate most agreements with insurers, which won’t cover enrollees if a third party is paying part of their premium. CMS had also accused dialysis centers of “steering” patients away from Medicare and Medicaid into private plans to boost their own reimbursements.

The ruling determined that beyond skipping the public comment, CMS “failed to consider the benefits of private qualified health plans and ignored the disadvantages of the rule.”

“This discriminatory rule would single out dialysis patients for denial of basic patient protections by insurers that want to dodge their responsibility for covering the costs of potentially lifesaving care,” Hrant Jamgochian, CEO of Dialysis Patient Citizens (DPC), one of the plaintiffs in the suit, said in a statement. “The rule would also give insurers a financial incentive to restrict services and limit the treatment choices of dialysis patients who they are about to throw over to Medicare.”

In its own response, DaVita asked the new administration at CMS to eliminate the rule altogether and “take action to prevent insurance companies from discriminating against a vulnerable group of patients and ensure continued access to charitable premium assistance.”