Policy change worries patients who depend on life-saving dialysis

( Image: American Kidney Fund )
( Image: American Kidney Fund )

HONOLULU (HawaiiNewsNow) - Beginning Feb 1, HMSA will no longer accept premium payments made by third parties. That includes the American Kidney Fund.

The fund pays premiums for 115 HMSA members who use the insurance to pay for life-sustaining dialysis.

Jeffrey Wong worries switching to public insurance won't cover all his medical bills and could disrupt his dialysis treatments.

"If I didn't pay HMSA to cover myself then I would go back to Medicare or Quest or state or one of the other federal agencies. That will probably cost me between $600 and $800 in medicine alone," he said.

Federal regulators have accused American Kidney of violating the nation's Anti-Kickback statute by steering patients to dialysis centers that donate money to its fund. Reimbursements to those centers are high and some of the money gets donated back to the kidney fund.

"When you have an entity that has a financial interest in where people receive services and treatment that constitutes a conflict of interest," said Elisa Yadao, HMSA's senior vice president of Consumer Experience.

HMSA notified its members of the change late last year and has been trying to locate all 115 people who are being affected. But dialysis patient Salome Tupou is still confused and concerned by the policy shift.

"I don't have the money to pay out-of-pocket. Where the money will come from, I just don't know." she said.

Yadao said of the 115 affected members, 100 already have secondary coverage for their dialysis.

"In many instances, Quest is a better option for people. You pay very little, if any, co-pays," she said. "Quest will cover things like if you have to pay to get from your home to the treatment center and back, those are covered by Quest."

But Darren Maluyo doesn't like the idea of moving away from his commercial plan, and worries it will affect his ability to continue working as a chef.

"There's other options on the table. One of them was disability. I don't want to go on disability. I'm strong enough to work," he said.

[Learn more about HMSA's premium policy by clicking here.]

HMSA said it apologizes for the worry some of its members are feeling and hopes those who have questions about third-party premium payments contact them right away.

"We are absolutely committed to making sure that people have access to treatment today, tomorrow and the day after," Yadao said.

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