Dialysis Coverage Suit Dismissed
DaVita, one of the two dominant dialysis providers, filed a lawsuit against natural food company Amy’s Kitchen for trying to limit the amount of benefits plans pay on dialysis claims. DaVita claimed that the plan violated the Medicare Secondary Payer Act (MSP) and ERISA by taking dialysis providers out of network and paying dialysis claims at Renalogic-recommended “Usual and Reasonable” rates. The fact that this decision was issued so quickly – literally the day after it was argued – indicates the court found Amy’s Kitchen’s arguments highly persuasive.
With this quick dismissal, it is clear that plans can and should resist dialysis provider pressures to avoid cost containment. With a well thought-out program and a willingness to stand by claims decisions, plans can bring their dialysis costs down, and keep them down.
Lisa Moody, CEO of Renalogic, shares, “Renalogic is honored to have helped Amy’s Kitchen achieve this court victory by providing strong cost containment plan language and by supporting research and analysis in the litigation. Since our founding, Renalogic’s mission has been to partner with self-funded employees to do the right thing — to not only contain costs for dialysis, but to also make dialysis itself obsolete by improving the health and wellbeing of every employee. This case is a pivotal step in the right direction.”
Renalogic, the pioneer and leader in dialysis cost containment for nearly two decades, is committed to resolving the significant costs of dialysis by empowering clients with alternative solutions, improving each members’ health, and reversing the progression of kidney disease. Renalogic continues to revolutionize the industry through its new Kidney Dialysis Avoidance Program (KDAP), which proves that dialysis and its costs are avoidable.
Renalogic, headquartered in Phoenix, AZ, was founded in 2002 as a specialty dialysis cost-containment company to help clients understand the unique market dynamics in the dialysis provider community. The company has evolved to become a comprehensive provider of data-driven, end-to-end chronic kidney disease (CKD) care and cost management programs for the self-insured industry. Renalogic’s professional team includes leaders in healthcare administration, care management, legal specialists in ERISA and healthcare law, contract negotiation, payer/provider negotiation, and clinical experts.