California Physicians Oppose November Proposition That Would Put Dialysis Patients' Lives at Risk April 27, 2018 Legislative Update, Legislature 1134 On April 26, the California Medical Association (CMA) announced that the organization opposes the proposed November ballot proposition that would impose arbitrary limits on what insurance companies reimburse dialysis clinics to provide patient treatments. By setting reimbursement rates artificially low and at a level that does not cover the actual cost of providing care, the measure would force many community dialysis clinics to reduce operations or even close. This would dangerously reduce access to care for dialysis patients who need treatments three days a week, for hours at a time, just to survive. "For patients whose kidneys have failed, receiving dialysis is necessary to live," said CMA President Theodore M. Mazer, M.D. "Missing even one appointment could be harmful or fatal. By limiting access to dialysis care, this dangerous proposition puts patients' lives at risk." As proof of the measure's poor drafting, the proposition's definition of "patient care services costs" – what dialysis clinics can bill insurance companies under the proposition – excludes many necessary costs to provide high-quality care, including the exclusion of physician medical directors. Medical directors manage care and treatment plans for a clinic's patients, and each clinic is required to staff a medical director as a requirement of the federal Centers for Medicare and Medicaid Services (CMS). "Excluding the physician medical director, who is required to oversee patient treatment in every dialysis clinic, is proof that this measure is seriously flawed and would hurt both access to care, as well as quality of care, for dialysis patients who are very ill," said Dr. Mazer. "This proposition is dangerous and must be defeated." In its opposition to the dialysis proposition, CMA is joined by more than 60 other organizations representing doctors, nurses, patient advocacy organizations, community dialysis clinics, veterans' groups and others. For more information, visit nodialysisproposition.com. # # # The California Medical Association represents the state's physicians with more than 43,000 members in all modes of practice and specialties. CMA is dedicated to the health of all patients in California. For more information, please visit CMAnet.org, and follow CMA on Facebook, Twitter, LinkedIn and Instagram.