say what
Joined: 11 Mar 2003
Posts: 29
Posted: Sun Nov 16, 2003 8:13 am Post subject: The US Senate again? What is it they arent getting?
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I was wondering if you could post another message for me. We have heard<
>that Davita may be pressing patients to write to Congress about inadequate<
>payment for dialysis. I have not talked to any patients that have<
>confirmed this. We have been told that this is a Davita only issue, but<
>have no evidence to support the allegation. We are trying to determine if<
>patients are being forced to send in letters and if this is a problem.<
><
>Patients can contact me via email or phone. Thanks for your help.<
><
>Michelle Anderson<
>Investigative Auditor<
>202-224-1374<
>
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DaVita patient
Joined: 16 Nov 2003
Posts: 2
Posted: Sun Nov 16, 2003 9:19 am Post subject: reimbursement
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Yes was presented with a letter in June 2003 to sign and place my address at the bottom of the letter. Of course all of this was during my treatment. Did I sign and give back to staff? Of course not. Have document in my possession if you need it.
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Not Fooled
Joined: 16 Nov 2003
Posts: 1
Posted: Sun Nov 16, 2003 9:37 am Post subject: Davita pressuring patients to write letters
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This is absolutely true! First they conditioned patients by handing out newletters each month. The newsletters are total propaganda! There are cheery articles about how wonderful and caring Davita is and about how they love to educate patients. This is total hogwash!!! <
><
>The staff are only trained in how to get patients on and off the machine with jiffylube type speed and are very lacking in educational preparation for the job. They hire people as pcts who are very gullible who believe what they are told and will follow orders to a tee. When the tx goes wrong, they just quickly give patients a shot of supertonic saline. Or they keep patients so high above their dry weights that they don't cramp, but stay fluid overloaded. They don't give factual answers to the patients'questions as they aren't educated enough to know the correct answers. <
><
>Most of the techs think they are giving the correct answers as they've been programmed to give incorrect, pat answers, or answers that blame the patient for the problem he is having, or answers that make the patient think there are no answers to his particular problem. <
><
>Even the nurses are only minimally educated on the dialysis tx. They know what's going on as far as cutting corners and as far as care and supplies. But they are under the same delusion as pcts as far as truly understanding the tx and delivering safe care. <
><
>Don't want to leave out the doctors. They don't know one button from another on the machine. They say it's not their dept., but it is impossible for doctors to understand patients' problems with tx if they don't know how the machine affects the patients' bodies. DaVita doctors at my unit rush through the rounds and give very incorrect/incomplete answers. <
><
>DaVita is not about the quality care and education they praise themselves to have in their newsletters. They are about profits. And after conditioning patients with this propaganda, they then hit us up to write letters for more reimbursements. In our unit, they had a tech come around to each patient with a notice and told us they wanted us to write the letters. This is how DaVita operates.<
><
>
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DaVita patient
Joined: 16 Nov 2003
Posts: 2
Posted: Sun Nov 16, 2003 10:04 am Post subject: DaVita's training program
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I've had many techs since being on dialysis and most of them are very easily manipulated by the company. But I've had 2 or 3 who told me honestly that they were very incompletely trained. They said they felt very badly that they couldn't provide correct tx information and said they felt terrible that we were not getting good care. But they said they had to watch what they said or they could lose their jobs. DaVita really cracks the whip and keeps the techs moving all the time. They work long hours and lots of errors occur as they are spread so thin and don't catch up on their rest. It's hardly educational at our unit and it's difficult to get their attention if you need them.
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Sun Nov 16, 2003 11:39 am Post subject: Davita Patient
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I would go make a copy of the document and mail it to the lady. Keep the original.
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FRN
Joined: 24 Feb 2003
Posts: 25
Posted: Sun Nov 16, 2003 1:01 pm Post subject: Davita is not the only one!
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When I worked for RCG, they also "encouraged" their patients to write and ask for more money. They also gave out "Sample letters" that you could use by just filling in the blanks with your name, dialysis company, etc. They would even give you an pre addressed envelope to sent it in. <
><
>Patients were told that this was the only way the company could "improve" the "care" the patients got. <
><
>BS! If less went to their precious "Stockholders", and more to paying to educate the patients, the staff and keep qualified staff in place, then the patients would be a lot better off in the long run. But NOOOOOOOO! As were were told, "We owe it to the stockholders to make a profit"!
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newbie
Joined: 16 Nov 2003
Posts: 2
Posted: Sun Nov 16, 2003 4:04 pm Post subject: Stockholders
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Can someone tell me how this stockholder thing works? I've heard about it, but don't fully understand how it can be legal to have dialysis patients on the stock market. I mean what kind of thing is that to do? It enrages me to think that the public can take out stocks on our misfortune for having kidney disease. Am I looking at this wrong or is this inhumane? I can tell you there's no worse feeling in the world than knowing that my doctor and staff don't genuinely care about me and only seek to profit off my disease.<
>
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Mon Nov 17, 2003 1:14 am Post subject: stockmarket
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Actually Kidney patients are not on the stock market. The doctors that own and operate treatment centers can sell the treatment center to the large dialysis corporate chains. In can be said that the chains are paying the doctors for the patients, but actually there is equipment and real estate involved so the patients are not actaully being 'sold'.
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say what
Joined: 11 Mar 2003
Posts: 29
Posted: Mon Nov 17, 2003 5:47 am Post subject: What commodity is there
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Buy machines? The machines are paid or leased by the government anyhow. <
>How many of you are dializing in store fronts or rented office buildings?
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aware
Joined: 17 Nov 2003
Posts: 5
Posted: Mon Nov 17, 2003 5:49 am Post subject: real estate?
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/>
most dialysis clinics are "storefront" operations therefore no real estate is included in the sale.
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Pollyanna
Joined: 18 Mar 2003
Posts: 22
Posted: Mon Nov 17, 2003 5:54 am Post subject: safe harbor
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This is the only group of physicians that are immune from the Stark Law and the Anti-kickback law,as they receive the "safe harbor" which allows them to profit off their patients.<
>Call it anything you want, but without the patients, they have no commodity. If you base it on business, what is their business? The companies base the buying price per patient, on how much the clinics generate. We have supplied the press with the document of sale, and it doesnt say machines. This is the only group of physicians that are allowed to profit off patients.
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where do you get
Joined: 17 Nov 2003
Posts: 1
Posted: Mon Nov 17, 2003 12:33 pm Post subject: the idea
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that the government pays for or leases the machines?? please provide a credible source because i'm sure my company would love to know how to get them to do it!!!!
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Call
Joined: 17 Nov 2003
Posts: 1
Posted: Mon Nov 17, 2003 1:47 pm Post subject: You can get the information from
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Gene Richter in Baltimore, Maryland....he is in charge and will send anyone a copy of that information. This has been on our site before.<
><
>I have called Ida and will have his number so you can personally call...she is not in her office.<
><
>I would suggest that you call them. I will post the number then. Or you can call CMS yourself...! I would suggest that you call your local ESRD Network and they will give you Ida's number. Its simple and hope you will share with all of us!
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CALL 1800MEDICARE
Joined: 18 Nov 2003
Posts: 1
Posted: Tue Nov 18, 2003 5:52 am Post subject: FOR YOUR ESRD COVERAGE FROM MEDICARE
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Call and get a copy. Its there.
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cks
Joined: 30 Jun 2003
Posts: 12
Posted: Tue Nov 18, 2003 6:44 am Post subject: Method II v. Method I
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I think you are confusing Medicare's Method I and Method II. Method I is the prospective composite payment per dialysis treatment, while Method II is available for patients who deal directly with suppliers, most often PD patients though it could be done by home hemo patients (George Harper for instance). Out patient dialysis facilities all bill under Method I. The government does not rent, buy or lease the machines under Method I.<
><
>As to the sale price of units implying that dialysis patients are being bought and sold on the stock market, I think that is a stretch. After all there is nothing holding patients to a unit besides inertia and/or lack of competition, which can change in a day. Most businesses are sold on the basis of revenues, in dialysis revenues can be put in terms of patients but noone owns the patients, they can all leave tomorrow ? in theory.<
>
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say what
Joined: 11 Mar 2003
Posts: 29
Posted: Tue Nov 18, 2003 7:40 am Post subject: what is the commodity
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What generates your revenues? If the patients leaves freely does their doctor practice in another clinic? Does the patient have to get a new doctor? In many cases the other clinics wont take in new patients if they are dismissed from another clinic. Some times all the clinics are owned by the same company. Can you complain in a unit? I am afraid until now, the dialysis industry has had it their way, not anymore it appears.<
><
>I am afraid it is not a stretch,I wish it were. Everything we as an organization stated in the beginning was not believed as we were conspirator's and lying. It appears that we are and have been validated. Please read the GAO report. We have just started and have moved to more players that are outraged.<
><
>It is the patients who are the only money maker in the equasion. If you have no patients, you have no money, as the government is paying for care. That is what this business is all about. Patient care.<
><
>What do you generate your revenues off of? Machines that are payed for, or leased?The composite rate that pays for supplies and the staffing? Reuse when a patient can chose a new dializer each treatment? The money makers are reuse and epogen, that is what the revenues are about? Who is the receipient of the epo or a dirty dializer that they havent been given the right information on? <
><
>You are making the revenues off the patients. The money is intended for patients and not the lack of care that they receive now. Read the current GAO report and the one from our hearings in 2000. I was right about the industry then, and the medical directors are making a killing as with the companies with their patients on the stock market.<
><
>It is up to $100,000 a patient in the companies own litature. They can call it anything they want, slant it anyway they chose. I would guess you are industry! You have a lot to lose, as we are still continuing on,as you can not see what horrors that our patients have endured,or care. We do as these are human beings who have not had any rights, and dying like flies. The industry owned everything and policed themselves. Guess what, that day is coming to an end. I will personally continue forward. I am not done yet!<
><
>All I can say to you, that there will be two or more hearings in this industry. Many in DC are outraged, as they realize that it isnt about paying for patient care, it is about profits and according to the GAO, the patient care sucks in this industry. Guess I wasnt wrong in 1998 was I. It appears that we will continue on and we are in the best place possible to make the changes. Let Joe and Josephine public decide how their dollars are not going to patient care but to the stock market. I personally feel you are already stuck in the corporate matra, but our evidence so far has not been wrong!<
><
>The part that is the saddest is that the Senate knew in 1998 and put up NO SAFETY NET to protect the patients. Let Joe and Josephine public decide how they feel about that.<
><
>Please explain the symbols of stock DVA, RCI, FMS when the industry has been crying for more money. Check the stocks! Oh! I guess they are trading on epo and rented store fronts in alot of cases! I am secure with my information and boy, will you be suprised.<
>Arlene
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Tue Nov 18, 2003 8:31 am Post subject: to CKS
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It is my understanding that medicare will not approve a new unit in a area for reimbursement of expenses if there is already a unit in the area. Seems to be a controlled market - no competition allowed. At least that is how it looks to me.
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FRN
Joined: 24 Feb 2003
Posts: 25
Posted: Tue Nov 18, 2003 9:01 am Post subject: Insurance companies
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Many patients who have additional insurance are limited to which Dr.s they can go to by their insurance companies. Insurance companies contract with certain Dr.s to provide care to their clients. ( for example Kaiser patients) These Dr.s have privileges to practice only at certain facilities. So this limits a patients choices even more. And when changing insurance companies, some will not cover a pre-existing condition. So the argument that patients can come and go as they please holds no water. Patients have to go where their Dr.s have privilages to practice, otherwise the patient has to find an new Dr. and patients can not run without a dialysis prescription from a Dr.<
><
>If there were no patients out there needing dialysis, then
there would be no need for dialysis facilities. There would be not dialysis companies, and those companies would not be trading on the stock market. <
><
>The patients are the "commodities" these companies are "trading" in. Without them there would be no "business".<
><
>The dialysis companies do make a lot of "profit" from reselling EPO to the patients. I hope that you patients are getting itemized bills from your facilities, insurance companies, or whoever is paying your bills. If not, insist on getting those bills itemized. I think many of you will be shocked to see just how much is being charged for EPO and other items. Be an informed consumer!
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