Tuesday, January 3, 2017

NYT Exposes Kidney Fund Nefarious Activities to Game System with Clinics

Is Any American Institution Untouched by Corruption?

The federal government has set up a unique program to allow a charity group to collect funds from clinics and then use those funds to benefit the clinics.

The Kidney Fund’s payments are part of an unusual deal it made with the government and the dialysis industry 20 years ago. The arrangement allows the dialysis companies to avoid violating anti-kickback laws. It allows dialysis clinics to donate to the Kidney Fund, treat patients whose insurance premiums are paid by the charity and then collect money from the insurers for those patients’ treatments — essentially guaranteeing a steady stream of paying customers for the companies.

One important thing here, though.

Under an agreement with the federal government, the Kidney Fund must distribute the aid based on a patient’s financial need. But the charity has resisted giving aid to patients at clinics that do not donate money to the fund, an investigation by The New York Times has found.

So what is going on here? Well this.

In multiple cases, the charity pushed back on workers at clinics that had not donated money, discouraging them from signing up their patients for assistance. Until recently, the Kidney Fund’s guidelines even said clinics should not apply for patient aid if the company had not donated to the charity.

“I watched many patients who were not able to get that assistance,” said Elaine Brecher, a former social worker at a small clinic in rural Arkansas. After an application for one patient was declined, she said, she did not apply for others, because a colleague believed that only clinics that donated could refer patients.

The Kidney Funds denies all wrong doing.

In an interview this month, LaVarne A. Burton, the Kidney Fund’s chief executive, said that the charity treated all patients equally, and that the fund had never denied anyone assistance if they qualified financially.

“It is simply not true that we require any provider to contribute to the program,” she said. “Never have, and never will.”

But of course there is this.

This year, for example, the fund faced questions about whether it was helping dialysis companies game the Affordable Care Act. In some cases, insurers and government officials have argued, the dialysis clinics used the charity’s assistance program to push people who were eligible for Medicaid, government health insurance for the poor, into private health coverage available under the new law.

The private plans pay the clinics much more than Medicaid — up to four times as much, adding up to an additional $200,000 per patient per year — for the same dialysis treatment.
Cheating people dying of kidney failure, fun and profit in America. And just think of the opportunities once a man of Trump's character takes over.

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