Category: ESRD Prospective Payment System (PPS)

ESRD PPS: Updates to Policies and Payment Rates

CMS issued a final rule that updates payment policies and rates under the ESRD Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2018. In addition, this rule finalizes updates to the acute kidney injury dialysis payment rate for renal dialysis services, as well as updates to the ESRD Quality Incentive Program for payment years 2019, 2020, and 2021. CMS projects that the updates for Calendar Year (CY) 2018 will increase the total payments to all ESRD facilities by 0.5 percent compared with CY 2017. For hospital-based ESRD facilities, CMS projects an increase in total payments of 0.7 percent, while for freestanding facilities, the projected increase in total payments is 0.5 percent.

The final rule also includes:

  • Update to the ESRD PPS base rate
  • Annual update to the wage index and wage index floor
  • Update to the outlier policy

See the full text of this excerpted CMS Fact Sheet (issued October 27).

CMS Proposes 2018 Policy and Payment Rate Changes for End-Stage Renal Disease Facilities

Proposed rule builds patient-centered system of care to increase competition, quality and care.

 

CMS has issued a proposed rule that would update payment policies for the ESRD Prospective Payment System (PPS). The ESRD PPS proposed rule is one of several for calendar year 2018 designed to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.

The ESRD Quality Incentive Program (QIP) proposed changes are for payment years 2019, 2020, and 2021, and affect a number of key dialysis data methodologies and quality measures. The proposed rule also invites comment on how to include individuals with acute kidney injury in the ESRD QIP. 

For a fact sheet on the proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-06-29.html

The ESRD proposed rule (CMS 1674-P) can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/