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Some of CDC’s Accomplishments
· Sponsoring legislation, which streamlined and clarified the confusing hemodialysis technician training and testing law passed in 1981. · Sponsored legislation which authorized the administration of specified medications (e.g. heparin, saline, lidocaine) by hemodialysis technicians · Stopped several bills which would have prohibited reuse of dialyzers · Achieved many needed modifications in the State reuse regulations and worked with the Department of Health Services (DHS) to obtain a favorable interpretation of the dialyzer reuse consent law to make it clear that a patient does not have the "right" to demand a new dialyzer for every treatment when they are on a high flux dialyzer · Sponsored legislation, which reduced clinic licensure fees by an average of $1000 per year, per facility. · Stopped DHS when they attempted to eliminate Medi-Cal/Medicare cross-over payments · Strenuously opposed and ultimately defeated several attempts by the state to eliminate non-emergency medical transportation provided to the dialysis patient under the Medi-Cal program · Worked with both state and federal fiscal intermediaries to improve the ESRD claims processing procedures. · Established (1992) an administrative office to serve as a resource for the CDC membership. · Worked with DHS and EDS to add InFed® to the Medi-Cal formulary to replace the less expensive but unavailable Inferon and to establish Medi-Cal reimbursement for EPO and Urokinase to be in line with that of Medicare. · Established an ESRD Network Liaison committee to work with Networks 17 & 18 · Sponsored legislation which eliminated duplicative reporting requirements of the Office of Statewide Health Planning & Development (OSHPD) as required in the State Annual Report of Clinics · Developed a "Managed Care Document" as an aid to facility members in the education of Managed Care Organizations regarding dialysis · Worked closely with ESRD Network 17 and DHS after the 1991 Northridge earthquake to educate members on disaster preparedness. · Established liaisons with national ESRD organizations to influence federal issues
To quantify just a few of our accomplishments (based on an 85 patient hemodialysis unit):
· Licensing fees: the decrease in licensing fees averaged over an 85 patient unit that performs 13,260 treatments per year is $0.08/treatment · Without Medi-Cal transportation, patients would miss treatments, resulting in lost revenue to the facility and an increase in hospitalizations. The statewide average of Medi-Cal patients is 27%. If seventeen patients have Medi-Cal and miss 10% of their treatments for a year due to ride problems, the facility loses revenue of almost $50,000 per year, or $3.75 per treatment averaged over the total treatments for the facility for the year. · Elimination of the Medi-Cal crossover, taking into account the 20% of the composite rate, and 20% of the average amount of reimbursable medications, would amount to $44.02 lost revenue per treatment. · Eliminating reuse of dialyzers, taking into account reprocessing equipment, supplies, and labor would still result in a loss of $13.03 per treatment. · The legislature proposed to eliminate 12/13 of the monthly capitation fee paid to nephrologists for Peritoneal Dialysis patients. The rationale was that they were seen in clinic only once a month. Decreasing this reimbursement would have result in a loss of $6.65 per treatment averaged over 30 PD treatments per month. · These savings add up to over $60.88 per treatment, not including the nephrologist PD fee!
Where would your clinic be without the efforts of the CDC? Please support the CDC by joining your clinic as a member. Without your support, the California dialysis industry will lose its most effective advocate in Sacramento!
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