Let HHS know that charitable premium assistance is important to patients

Contact HHS today

For tens of thousands of U.S. dialysis patients who are in great financial need, the American Kidney Fund provides a lifeline of care. Our Health Insurance Premium Program (HIPP) is a charitable premium assistance program, and it helps more than 70,000 low-income dialysis patients each year to maintain their health insurance coverage. The U.S. Department of Health and Human Services (HHS) set forth guidelines nearly two decades ago allowing us to operate this vital program, and today, we are asking HHS to take a simple action that will enable us to continue running this program in the manner that is best for patients.

Some insurance companies no longer want to accept payments from organizations like AKF and other charities. Unclear, ambiguous guidance from the federal government has resulted in insurance companies feeling emboldened to reject health insurance assistance. We are asking the HHS Secretary to clarify this guidance so that insurance carriers will continue accepting payments from independent, public charities like AKF. Requiring insurance carriers to accept our payments on behalf of patients will ensure that no dialysis patient loses health coverage due to non-payment.


  • Secretary Alex Azar


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Question - Not Required - What is your connection to kidney disease?



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Please clarify IFR on payment of qualified health plan premiums made by charities

Dear [Decision Maker],

As someone who has been affected personally by kidney disease, I am writing to ask that the Centers for Medicare and Medicaid Services clarify the Interim Final Rule on third-party payment of qualified health plan premiums (CMS-9943-IFC). CMS' guidance on this issue has resulted in confusion that is jeopardizing the health coverage of many patients.

The American Kidney Fund (AKF), the nation's largest nonprofit serving people with kidney disease, helps more than 70,000 low-income dialysis patients in all 50 states maintain their existing health insurance coverage. AKF runs its Health Insurance Premium Program (HIPP) under HHS Advisory Opinion 97-1. AKF typically pays patients' insurance premiums directly to carriers. Through this third-party payment process, AKF pays patients' insurance bills in full and on time. This process makes common sense: it keeps patients insured. No patient loses coverage due to non-payment.

Because the Interim Final Rule is ambiguous in its application to independent, publicly supported charities, many insurance carriers are refusing payments from charities like AKF.

CMS could fix this situation, and could thereby protect low-income patients, by clarifying the Interim Final Rule to require that health insurance carriers accept premium payments on behalf of patients from independent, publicly supported 501c3 charities like the American Kidney Fund.

[Your Name]
[Your Address]
[City, State ZIP]