Dialysis Patient Protection: Insurers Must Cover Costs Before Medicare.
This law strengthens financial safeguards for individuals with End-Stage Renal Disease (ESRD) requiring dialysis. It prohibits private group health plans from treating dialysis services less favorably than other covered health services, preventing them from shifting primary payment responsibility unfairly onto the Medicare program. This ensures patients receive equal benefits regardless of their ESRD diagnosis.
Key points
Group health plans must provide the same level of benefits for dialysis and ESRD as they do for other conditions, without imposing discriminatory limitations.
Insurers are explicitly barred from forcing Medicare to become the primary payer for dialysis costs prematurely or inappropriately.
The law confirms that health plans retain the right to choose which specific renal dialysis providers are included in their network.
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