On Monday, July 2, CMS issued a proposed rule that would update Medicare policies and payment rates for dialysis facilities, while strengthening incentives for improved quality of care and better outcomes for beneficiaries diagnosed with End-Stage Renal Disease (ESRD).The proposals would affect payments for outpatient maintenance dialysis treatments furnished on or after January 1, 2013 under the bundled ESRD Prospective Payment System (PPS) that was implemented in calendar year 2011.
CMS is projecting that payment rates for dialysis treatments will increase by 2.5 percent, representing a projected inflation (or ESRD bundled market basket) increase of 3.2 percent reduced by a projected productivity adjustment of 0.7 percent. CMS estimates that payments to ESRD facilities in 2013 will total $8.7 billion. The proposed rule also proposes changes to the ESRD Quality Incentive Program (QIP) that provides payment incentives to dialysis facilities to improve the quality of dialysis care. Under the QIP, facilities that do not achieve a high enough total performance score with respect to quality measures established in regulation receive a reduction in their payment rates under the ESRD PPS. Please refer to the ESRD QIP<https://www.cms.gov/Medicare/End-Stage-Renal-Disease/ESRDQualityImproveInit/index.html?redirect=/ESRDQualityImproveInit/> website for more information. CMS is also proposing to codify the provisions of section 3201 of the Middle Class Tax Extension and Job Creation Act of 2012 (Pub. L. No. 112-96) that requires reductions in bad debt reimbursement to all Medicare providers eligible to receive bad debt reimbursement; these provisions are specifically prescribed by statute and thus, are self-implementing. This reduction in bad debt reimbursement is projected to yield savings to the program of $10.9 billion over 10 years. The rule (CMS-1352-P) can be viewed on the ESRD Payment Regulations and Notices<http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/End-Stage-Renal-Disease-ESRD-Payment-Regulations-and-Notices.html> website. ________________________________ If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads//MailingLists_FactSheet.pdf<http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MailingLists_FactSheet.pdf> and select the appropriate listserv to subscribe. If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/About-CMS/Agency-Information/ContactCMS/index.html). Thank you.
