Worker Bee
Joined: 29 Oct 2002
Posts: 28
Posted: Thu Aug 14, 2003 4:57 pm Post subject: Delaying tactics, so familiar to us.....
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Sounds like the same sort of promises that were made to us after the Senate Hearings in 2000. Here it is over 3 years later and we have still to see any thing come out of those hearings. We were promised standards of care 6 months after the Senate Hearings, we are still waiting. The companies still dump patients left and right and CMS says they can't do anything to protect these vulnerable AMERICAN CITIZENS! Sorry, but until I see them actually put something into law and see changes down on my level, that is in the trenches so to speak, it is still all hot air. <
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>They have known about the problems since the Senate hearings. They have had multiple investigations, all stating that there are major problems. Yet in 3 years they have done NOTHING! Their word is not worth the energy they excert to speak those worthless words. The AMERICAN HOLOCOST STILL GOES ON RIGHT UNDER THEIR NOSES WITH THEIR FULL KNOWLEGE OF EVERY DUMPING! Their inaction signifies their approval of what the companies, the worthless networks, and Medicare allows to happen each and every day. <
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>I am afraid that nothing short of widescale public awarness, public protests, marches and demonstrations, will get them off their butts to do anything.<
>How long do we have to wait? How many more patients have to die? Why do they ask for more time to investigate? Why, why, why? <
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>WHERE DOES THE BUCK STOP? WHO AT CMS WILL TAKE THE INITITIVE AND SAY I HAVE THE POWER TO STOP THIS HOLOCOST? WHO WILL STAND UP AND DO THE RIGHT THING? <
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>The above proposed changes in how Nephs are paid will do nothing to stop what is going on. The companies will find the loop holes and get around these new rules. They are expert at it. IT DOES NOT EVEN BEGIN TO ATTACK THE PROBLEMS THAT DEO PRESENTED AT THE CMS MEETING! I have to agree with Ridgerunner, it is a lot of hot air! <
>So get ready everyone, the ride of your life is coming! Hang on!
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Fri Aug 15, 2003 3:41 am Post subject: 4 visits
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I do not see how this is going to improve anything. The labs are only drawn once a month. Currently the doctor comes around, asks 'do you need anything' then reads your lab results into a tape recorder, signs a few things in your chart and off to the next patient. If he has to come around 4 times in a month the other 3 I guess will be 'do you need anything' only visits? Is that really productive? How will that improve the quality of care?
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John
Joined: 18 Nov 2002
Posts: 8
Posted: Fri Aug 15, 2003 5:03 am Post subject: 4 visits
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4 visits is what I would want if my doctor was good. I have questions throughout the week and waiting a week to see the doctor is long when there is a question. And its important to see the doctor weekly for rx's. It's aggravating to call the office for that. So 4 is good and he's getting paid $300+ for that. I think that's fair. But he could come 16 times a month and it wouldnt help if he's not going to do more than run off as fast as he can and not answer questions clearly.
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dialysis patient also
Joined: 27 Apr 2003
Posts: 7
Posted: Fri Aug 15, 2003 7:10 am Post subject: Refills
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Got Refills?? How about a simple antibiotic for a cold. I go to a neph that practices alone not in a large group. Tracking him down at one of his clinics is a pain because he is spread thin.
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Fri Aug 15, 2003 11:31 am Post subject: dr visits
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i see my doctor about four to six weeks iget a full exam of all my health problems any questions are addressed. if i need to see him or have any questions he is only a phone call away. i have more important things to do than sit in a doctors office when i do not need him. quality not quanity are the important thing to me. i am also a home patient.
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Pollyanna
Joined: 18 Mar 2003
Posts: 22
Posted: Sat Aug 16, 2003 5:39 am Post subject: Do you notice..
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that CMS started out taking care of the main thing that affects them? How much money they put out. Typical isn't it? Take care of what affects the govenment first, then let the chips fall where they may! :">
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Meeting with CMS
Joined: 17 Aug 2003
Posts: 1
Posted: Sun Aug 17, 2003 7:17 am Post subject: MY SLANT ON THE MEETING
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The meeting in Baltimore was not only informative, but I feel fair. They listened took notes and admitted that there are problems in this program.That is really the first step towards any resolution.<
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>The security was amazing and took about a half hour to get through. Karen as the driver had to figure out how to open a rental car hood....just glad I was a passenger on that one. <
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>We were met by Mr. Augustine and really was impressed with him and felt that his heart is in the right place, changes will be happening and issues such as reuse will be looked into by the Admiral Jenks, as well as others soon.<
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>Karen gave a great slide presentation that was very professional and informative. The conflict of interest that is in this industry all the way to the NKF and their contributors in the industry, reuse issues,care,and my favorite the ESRD NETWORKS.VERY Interesting to say the least.<
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>Pat spoke from the heart on what it feels like to be a patients spouse and her slant on it,that patients and families should be able to work in full cooperation for the sake of the patients.<
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>Dr. Bays chaired the meeting and we did a professional job and we all worked in unison with each other. It was a sight to see how professional it was done. All of us should be proud at the level of professionalism that was shown up in Baltimore. The respect was returned by CMS. It appears that we can all work together for a common cause -- the patient,who is the most vital in this struggle for patient rights.<
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>The ESRD NETWORK needs to go.The fact that they have not improved and still have been operating as long as they have and have not improved.They feel that they are immune.They have been allowed to self police and to cover up the sins of the industry. My question as always has been if they are contracted for patients grievances and quality of care.....where have they improved in quality of care since our hearings? Also what quality of care and who provides the statistics? No matter how good the Standards of Care may be,,,,as long as they continue to do business as usual the patients are still at great risk. I think that we drove home the point that how much information does one
ing to the emperor, evidently boxes and boxes and being included in the follies of the NETWORK still the Network needs the information, as they still are aware of the situation and need more time. Well, no more time will be given.<
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>Personally I feel that we were heard and the information was provided, now it is up to them to protect the patients and to have an outside force other than the industry, until then nothing will change. We are greatful that they are working on this, but realize that we need to help them get the word out and will need to continue with the public awareness.<
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>It appears that the patient dumpings are not being addressed, this is information that we have
ought forth. This is critical as it is about life and death. This is on our front burner as the issue that needs to be addressed at this time and the Network needs to be aggressive and not always side on the clinics behalf. DEO
will go forward with the Public Awareness Campaign and demonstrations. The government will appreciate the help, as we have a part to play in this.<
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>I wish to thank all that were there and the government for recognizing DEO as one of the players in the industry. We will be working with CMS and continue to help in the areas we can, especially, and foremost, on behalf of the patients. It has taken all of our efforts to get here, and all our efforts in working together for resolutions.<
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>Arlene
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ridgerunnerdr bays
Joined: 17 Aug 2003
Posts: 1
Posted: Sun Aug 17, 2003 9:46 am Post subject: meeting
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arlene has done a great job. i think they kept looking for the leader but were unable to focus on one person. arlene has put over five years of here life in this and i think very few people know to what this has cost her personally both financial and emotionally. but very few people will be able to look back and realize they have been able to make the changes she has. we have won the first round but there are many more to go.
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patient
Joined: 29 Oct 2002
Posts: 137
Posted: Sun Aug 17, 2003 12:24 pm Post subject: meeting
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This is great. Was this a public meeting so that you could say what officials were there? How often will they hold meetings to which DEO will be invited to represent patients? What future role have they given for DEO to play? Will patients be invited to take a role? Was any reason given reagarding the lack of promised standards and enforcement subsequent to the 2000 hearings? What specific assurances were given that they will not sit on this situation and will move forward with it? <
>It sounds like a very professional presentation was put forward by those who represented DEO. I would really like to see patients be given the opportunity to represent the patient population at these meetings in the future.
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FYI
Joined: 15 Feb 2003
Posts: 72
Posted: Sun Aug 17, 2003 5:15 pm Post subject: Meetings
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The meetings were with the patients running the meeting and a family member of a patient. It was nice to have the patients point of view as that is what we are fighting for and they live it everyday. <
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>It was not a public meeting and CMS wanted only 3-4 people to be there from dialysisethics. Patients were the ones who did the meeting,and that has much more impact that a bunch of health care workers speaking. Karen is a transplant patient, Dr Bays is a home hemo patient and Pat is a wife of a patient that has taken a role in advocating for her husband. Personally I feel that this was the patients day and no one can tell what it feels like but a patient. The whole meeting was orchestrated by the patients and family. <
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>We have been promised that changes are coming soon and it appears that the Standards of Care will be coming also. I do feel personally that they hopefully will not sit on it...but have been through the government maze with the Senate Hearings in 2000 and was devistated that nothing was done. I do believe that we are taken seriously and we must continue to move forward with the public awareness and the demonstrations. Time has cost too many of our patients lives, so we are grateful that the changes will be coming, but if the ESRD NETWORK does patient complaints nothing will ever change to protect the patients. <
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>I think all of us are in agreement that the patients role is what is going to be the most important. We should rotate patients in any future meetings perhaps. It is really hard to know who everyone is...as we are an anonymous board. I pray for the day that we get to the point as an organization that it is no longer needed to fear retaliation and have rights and choices as citizens of this nation.<
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>I do believe that we will be included, but we need to be active in change and move in a forward motion toward change. To work with the government would be nice, but to have the rules and regulations to happen soon would be great, but we have the expose and we can only hope the government does what is right by the patients and stop any excuses. When one is "dumped" just because they can is wrong. The government needs to move fast. We need to move forward and help when needed,and be vigilant in not accepting anything but real action and change from the government.<
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>I have gotten to where I dont trust the promises, but I do believe that Mr. Augustine and Admiral Jenks have a complete scope of the issues, I do believe that something will be done. But we also need to stay on course and get the word out.<
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>It has taken much work from many, but I do believe that soon the patients will have rights,quality of care and rights as citizens of this nation and not to fear retaliation and abuse.<
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>We are trying to set up committees to have work groups in areas of concern...it is getting much to busy and volunteers are needed to help.....!<
>
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patientwife
Joined: 18 Jul 2003
Posts: 47
Posted: Mon Aug 18, 2003 1:33 am Post subject: More on CMS Proposed Rule re Physician Pay
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Following was taken from an American Medical News article, "CMS Sticks to 4.2% Medicare Pay Cut". Go to amednews.com for full article.<
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>"The rule also would make several payment changes for specific physician services.<
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>The agency has proposed a new way to pay physicians for oversight of patients with end-stage renal disease. Medicare currently pays a fixed rate to physicians for medical oversight, without considering the patient's condition or the number of physician visits. The rule proposes three levels of payments. Physicians would be paid the lowest amount if they see the patient only once a month and the highest amount if they see the patient four or more times in a month.<
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>Nephrologists surprised <
>Dale Singer, executive director of the Renal Physicians Assn., said the change in payment caught nephrologists by surprise.<
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>"We've had discussions with CMS and our own membership about frequency of visits and improving communication," Singer said. "But as far as the specifics of what was in the rule, we had no clue this was coming."<
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>Although the group is still analyzing the details of the proposed change, Singer expressed concern that the change was made outside of the established process for coding changes that allows for physician input.<
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>CMS said the move was prompted by a recent study that found more physician-patient contact time in hemodialysis facilities led to a lower mortality risk.<
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>Additionally, the rule would create special codes to allow physicians to bill for cardiac telemetry, a new technology that allows physicians to monitor heart rhythms via the telephone. And payments for removing benign and malignant skin lesions would be revised to reflect the size of the excision, rather than the type of lesion.<
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>CMS said it plans to issue a separate rule in the near future to revamp the way Medicare pays for drugs administered in physicians' offices. Because oncologists and certain other specialists rely on cross-subsidies from drug payments, that rule is expected to contain practice expense changes that also would impact the physician fee schedule."<
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>
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ESRD Patient Rep
Joined: 18 Aug 2003
Posts: 1
Posted: Mon Aug 18, 2003 1:34 am Post subject: CMS meeting
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I am familiar with other top CMS names, but who are Mr. Augustine and Admiral Jenks? When will CMS's next meeting be that inculdes DEO or was this a one time thing until furthur notice? Has DEO become ncorporated yet and does it now have a board?
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FYI
Joined: 15 Feb 2003
Posts: 72
Posted: Mon Aug 18, 2003 4:45 am Post subject: Meeting
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Evidently you must have a booklet with names and phone numbers,if you dont
know who they are. They are under Scully as a special advisors.<
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>We are a non profit now. We will keep advised on the next meetings. We are in constant contact with CMS.<
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>Yes we have a board.
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Mon Aug 18, 2003 4:49 am Post subject: ESRD Pateint Rep.
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DEO is working on making changes to benefit all the dialysis patients. All the people working to make thes changes are doing so on a volunteer basis to the best of my knowledge. No one is on a payroll. Some of the people working behind the scenes are patients and if it became public knowledge who they were they are in fear of retaliation. <
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>If you have a confidentiality concern or fear of who you may be talking to feel free to contact Arlene. You know who she is and that she will honor your privacy unlike people at the ESRD Networks it appears.<
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>If you want to make a substantial donation to DEO you are more than welcome to. Since DEO is not a non-profit at this time it would not be tax deductible on your personal returns.
