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July 01, 2010


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Peter Laird, MD

Bill, that would be good news and a testimony to all those that spent hours diligently reading and reviewing the bundle proposal with the myriad of comments sent in to CMS.

Denise Eilers

Bill, I certainly hope you are right. Home dialysis offers patients the chance to be in total control of their health and treatments. It only makes sense to encourage patients to fit dialysis into their present lifestyle of work, social life, and family. Otherwise, we continue the mindset of viewing CKD5 patients as sick and disabled. I personally believe that attitude is unconscionable.

roberta mikles

Bill, I agree also and hope you are right. Our group's (Advocates4QualitySafePatient Care) comments, as many others, focused on these areas. We have always supported home dialysis. In fact, there are many units now who are really pushing for home dialysis ( after the bundle was made public) with posters on walls, home dialysis material throughout the units, etc. My question is why didn't providers do this prior to the bundle? Well, we know the reason, don't we? Was the patient not important enough to have home dialysis pushed as it is now? The important thing is that providers are now more focused on home. And, of course, meds should not be excluded - providers had a great influence here to exclude - - their influence has outweighed what patients wanted many times BUT this time patients did not want inclusion. We can continue to hope that the OMB will approve. Thank you for continuing to keep us all aware of that which is happening.
Roberta Mikles RN
Patient Safety Advocate
San Diego, CA

roberta mikles

CORRECTION ---And, of course, meds should not be INCLUDED..

wow, sorry for that.


Can someone please help an uninformed, but interested, outsider on the oral meds question? Is it a good or bad thing that DaVita and Fresenius have their own pharmacy beenefits/specialty mail-order pharmacies? Thanks.

Bill Peckham

Pat in general I think it could be to the patients benefit for providers large and small to be in the loop as far oral medications. Like anything whether it is good or bad depends on the details - things like quality measures, payment amounts.

I hope that the PPS required under MIPPA will not include oral drugs but that drugs will be included and fairly reimbursed, once the GAO completes their report; at which time CMS will have implemented the appropriate quality standards and reporting.

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