Benesch Healthcare+ Dialysis & Nephrology Digest No. 27
Nephrology and Dialysis Practices
MARCH 2, 2022
SCOTUS questions appear to support DaVita's position in dialysis care discrimination case
Private plans are supposed to provide coverage for dialysis for the first 30 months before the patients can transition to Medicare and there's a statutory framework in place to ensure plans don't lowball reimbursement. On Mar. 1, SCOTUS heard verbal arguments in the case Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., in which the dialysis provider alleges the plan adopted reimbursement rates for dialysis services that were so low, members dropped their private coverage for Medicare. DaVita argues the practice is discriminatory but Marietta contends the dialysis plan is the same for everyone and so no differentiated care is being offered. Justice Sotomayor stated the petitioner's plan appeared "on the face of the statute not legal" because it doesn't adhere to the "reasonable and necessary costs" standard of the framework. Justice Kagan questioned whether a private plan could find an end around the differentiation measure in the statute by finding a proxy that would cover all members.
Related: Kagan puzzled by gov't bid to ax DaVita's dialysis win—Law 360
SOURCE: SCOTUS Blog
MARCH 21, 2022
Fresenius merging kidney care operations with InterWell Health, Cricket Health
Fresenius claims its merger with San Francisco-based Cricket Health and Waltham, Mass.- based InterWell Health will create the largest value-based kidney care organization in the U.S., with a valuation of $2.4 billion. The company will operate under the InterWell Health brand and the deal is expected to close by the second half of the year. By focusing on mid[1]and late-stage kidney disease, the partners predict that by 2025 it'll provide care to 270,000 patients and manage $11 billion in medical costs annually. The management team for the new InterWell Health will include:
- CEO Robert Sepucha, currently CEO at Cricket Health;
- President and COO David Pollack, currently president of the integrated care group at Fresenius Medical Care; and
- CMO George Hart, currently co-CMO at InterWell Health.
Related: Fresenius Medical creates kidney care business with InterWell, Cricket— Bloomberg
Fresenius Health Partners, InterWell Health and Cricket Health to merge— Healthcare Innovation
Executives at new InterWell Health, formed by 3-way merger, want to turn kidney care on its head—MedCity News
Healthcare merger aims to advance value-based kidney care—RevCycle Intelligence
5 takeaways from the Fresenius-InterWell-Cricket deal—Digital Health SOURCE: Fresenius Medical Care
MARCH 23, 2022
Global Nephrology Solutions rebrands as Panoramic Health
The Tempe, Ariz.-based company claims to have over 600 care providers in 15 states, serving over 275,000 patients with chronic kidney disease. The CEO of Panoramic Health, Rajiv Poduval, says the rebrand from Global Nephrology Solutions reflects the firm's commitment to holistic care with end-to-end solutions. Panoramic says it's the largest non-dialysis participant in Medicare's Comprehensive Kidney Care Choices model, serving nearly 10,000 patients in four states.
SOURCE: Panoramic Health
Benesch Healthcare+ Dialysis & Nephrology Digest No. 27
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