DOJ subpoenas dialysis chains, charity for information on premium assistance: 9 things to know

The Department of Justice has subpoenaed the nation's two largest dialysis chains, Fresenius and DaVita, seeking information about their relationship to a charity that helps needy patients pay insurance premiums, reports The New York Times.

Here are nine things to know.

1. The charity involved is the American Kidney Fund, which said it was also subpoenaed. The charity was the subject of a recent New York Times article highlighting concerns over whether the fund favored patients of its largest donors, Fresenius and DaVita, over those from smaller dialysis clinics that did not donate money, the report notes.

2. According to the report, the charity is not permitted to select patients based upon which clinic they use for dialysis per an agreement with the federal government. Selection for aid is supposed to be based on financial need.

3. When contacted by The New York Times, a spokeswoman for the U.S. attorney for the District of Massachusetts, which issued the subpoenas, declined to comment.

4. In a statement, DaVita said the subpoena sought "the production of information related to charitable premium assistance," and that "the company looks forward to working with the government to allow for clarity on these complex issues," according to the report.

5. A spokeswoman for the American Kidney Fund said the charity was cooperating with the DOJ's investigation.

6. The American Kidney fund contends it has not turned down a patient for assistance if the patient qualified financially, according to the report. "It is simply not true that we require any provider to contribute to the program," LaVarne A. Burton, the American Kidney Fund's CEO, said in an interview with The New York Times in December. "Never have, and never will."

7. The American Kidney Fund's premium assistance program has been the subject of close examination for months, after questions were raised about whether some dialysis companies were inappropriately leading patients eligible for Medicaid and other government insurance programs into more lucrative private insurance sold in the ACA marketplaces, reports The New York Times.

8. In December, CMS issued a rule requiring dialysis clinics to give patients more information about their insurance options and for insurers to receive notice when their customers' premiums are being paid for by a charity or other outside party, according to the report.

9. Large dialysis chains and patient groups have filed a federal lawsuit seeking to halt the rule.

 

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