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CMS proposes higher pay rates for end-stage renal disease

July 3, 2012
by pamela tabar
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The Centers for Medicare & Medicaid Services (CMS) proposed a policy change Monday that would affect the way facilities are paid for end-stage renal disease (ESRD) treatment.

Under the proposed rule, payment rates for outpatient dialysis services would increase by 2.5 percent next year, according to the CMS announcement.

To add incentives for quality improvement, performance data will be collected and used to determine future pay rates. ESRD facilities will be asked to provide performance data on their diligence on reporting infections, patient monitoring for anemia, tracking of patient calcium and phosphorus levels, and surveying customer experiences.

“As we enter the third year of our four year transition to the new fully bundled payment system for certain dialysis facilities, 90 percent of facilities are voluntarily receiving payments under the new system,” said Jonathan Blum, CMS deputy administrator and director of the agency’s Center for Medicare in a statement. “We believe that the policies and rate changes proposed today will continue to help ensure that beneficiaries diagnosed with ESRD continue to get the care they need.”

Qualitiy initiatives and the quality-based payment system for ESRD services were mandated in 2008 by the Medicare Improvements for Patients and Providers Act (MIPPA). If approved, the rule adjustments would begin in 2013. The quality performance data collected beginning in 2013 would determine the payments in 2015.

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