August 21, 2018
1 min read

Insurers, unions object to higher ESRD costs to pay for opioid treatment

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Health care plans, unions and business groups sent a letter to members of the U.S. Senate on Aug. 20 objecting to legislation that would extend the Medicare secondary payer provision for ESRD treatment by an additional 3 months to help cover costs for the opioid crisis.

H.R. 6, the SUPPORT for Patients and Communities Act, was passed by the House of Representatives in June and is under consideration by the Senate. To help cover the cost of rehabilitation of patients addicted to opioids, the bill would require private insurers to pay for an additional 3 months of ESRD services beyond the existing 30-month period after which Medicare becomes the primary payer. While the savings to Medicare would be $340 million, the letter states, the pass-along costs to insurers would be millions of dollars more because dialysis providers charge health care plans more than Medicare.

“As an offset, extending the period before which Medicare becomes the primary payer is bad policy,” the organizations wrote in the letter. “Shifting more of the cost of ESRD services would further burden private health plans at a time when they are already facing challenges in maintaining affordable coverage.”

The letter was sent to Senators Mitch McConnell, R-Ky.; Charles Schumer, D-NY; Orrin Hatch, R-Utah; and Ron Wyden, D-Ore.

The organizations cited an estimate by human resources consulting firm Mercer that private health plans will “be on the hook for approximately $48,000 per patient for the additional 3 months of ESRD coverage at a time when the number of people with ESRD has grown on average 7% annually,” they stated.

Paying higher costs for 3 additional months of ESRD treatment would force private health plans to “absorb the costs, raise premiums, or reduce coverage. These options are bad outcomes for workers and retirees,” the letter stated.

The letter was signed by America’s Health Insurance Plans; American Benefits Council; American Federation of State, County and Municipal Employees; Blue Cross Blue Shield Association; International Union; United Automobile; Aerospace and Agricultural Implement Workers of America; Service Employees International Union; The ERISA Industry Committee; the United States Chamber of Commerce and the United Steelworkers. –by Mark E. Neumann