CMS Notification of ESRD Members
Provider Type
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Health Net covers end-stage renal disease (ESRD) dialysis services, including peritoneal and hemodialysis, prior to the member's eligibility for Medicare.
- Hemodialysis - is usually accomplished in three, four-hour sessions per week. It usually takes place in an outpatient dialysis center with trained staff assisting the member
- Peritoneal dialysis - usually takes place in the member's home, after the member and/or caregiver has completed an appropriate course of training
Health Net members with ESRD are eligible for primary Medicare coverage after completion of the 30-month coordination period following the start of dialysis.
The dialysis center is required to file an ESRD Medical Evidence Report (PDF), CMS-2728 with the Centers for Medicare and Medicaid Services (CMS) to register a member that has been diagnosed with ESRD.