Centers for Medicare & Medicaid Services (CMS) issued a Medical Learning Network (MLN) Matters article #MM12188 on Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2021. The MLN Matters article is for ESRD facilities that bill Medicare Administrative Contractors (MACs) for services they provide to Medicare patients. The article tells about the Calendar Year (CY) 2021 rate updates and policies for the ESRD PPS and implements payment for renal dialysis services furnished to Medicare patients with Acute Kidney Injury (AKI) in ESRD facilities. Learn about rate and policy updates, and make sure billing staff are aware of these changes.
Category: Prospective Payment System (PPS)
CROWNWeb New User Training, QIP
CROWNWeb has announced that their next New User Training session will be held on December 11, 2018. Find details and register at http://mycrownweb.org/pcw_lems/dec-2018-crownweb-new-user-training/.
The December 2018 CROWNWeb Newsletter is also available, at http://mycrownweb.org/wp-content/uploads/2018/12/December_2018_Newsletter_V1.7-508.pdf. This issues includes articles on:
- The schedule for release of the PY2019 QIP reports and certificates:
- December 14, 2018 – PSRs and PSCs will be available to facility POCs on the ESRD QIP System at https://www.qualitynet.org/. PSCs must be prominently displayed in both English and Spanish within fifteen days of their availability and remain posted throughout the entire 2019 calendar year. Facilities without POCs are directed to call the QualityNet Help Desk at 866-288-8912.
- CMS expects to post the Performance Score Summary Report to DFC in January 2019, and to their Public Reporting & Certificates web page at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/08_ReportandCert.html by December 29, 2018.
- Questions may be directed to the QualityNet ESRD QIP Q&A tool at https://cms-ocsq.custhelp.com/app/homeesrdqip/p/960.
- A summary of the November CROWNWeb Town Hall featuring the Kidney Community Emergency Response Coalition’s (KCER) role in emergency preparedness and disaster response coordination, and their coordination with EQRS and CROWNWeb. Slides of the meeting can be found at http://mycrownweb.org/wp-content/uploads/2018/11/November_Town_Hall_Version_2.3_508-Compliant.pdf. More information on KCER can be found at https://www.kcercoalition.com/.
- A Clinical FAQ on Post-Weight Dialysis Assessment date.
- Scheduled CROWNWeb Clinical Closure Dates; note that your Network may require earlier data entry in some situations.
Announcement of a December 20, 2018 CROWNWeb Town Hall on 2018: A Retrospective Review. See http://mycrownweb.org/pcw_community_events/crownweb-town-hall-2018-a-retrospective-review/ for details and registration.
CY2019 Changes and Updates to the ESRD QIP & ESRD PPS
On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2019. This rule also updates the acute kidney injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities to individuals with AKI, and finalizes changes to the ESRD Quality Incentive Program (QIP). Find the summary at https://www.cms.gov/newsroom/fact-sheets/cy19-esrddme-nprm-cms-1691-f-and-dmepos-competitive-bidding-program-temporary-gap-period
ESRD QIP Payment Year (PY) 2019 CROWNWeb Reporting and Attestation Deadline
The Calendar Year (CY) 2017 End-Stage Renal Disease Prospective Payment System (ESRD PPS) Final Rule requires facilities to report data into CROWNWeb before the clinical month closure. As a reminder, all CROWNWeb reporting and attestations for the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) are due at the end of the last clinical month of the reporting period.
The second reporting period for the ESRD QIP Payment Year (PY) 2019 Pain Assessment and Follow-Up and Clinical Depression Screening and Follow-Up reporting measures, and the attestation period for the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Survey measure close on February 28, 2018, at 11:59 PM Eastern Time, which is in alignment with the December 2017 clinical month closure.
For upcoming deadline information, please see the monthly editions of the CROWNWeb Newsletter or ESRD QIP page on MyCROWNWeb.org” href=”http://r20.rs6.net/tn.jsp?f=001IYm3265Ea2-jhGBquyTSeMXKPeruW1Mu2hgf-RRhN6YRQOVkzWXioaofvRzC7Mniuj8zgfJ5D2f7Gujg3OqXJZeJ8Wfvssc3_oTnymZx9oUAdmIiYlG9xjDafSs9eWI8sT6JheZI_aPsGM6Oz3SX18_tARgSP4hywtez6ZEmf6Lo4N6UKJ8eF2KFffs43P2l45Fwy700wbaMmmgEAq-oSA==&c=C9y7cEQmMuz9fOBr6g2Jl50rzDFSaRza65EoGA2k0IhvxRBI9Kiy9g==&ch=KmrX_6AQMUqHL3yR3tTAL8T5bk7Xtey9_hTxreWsx5JLQ61qkLLdvA==” target=”_blank” rel=”noopener”>ESRD QIP page on MyCROWNWeb.org. If you have any questions or concerns, please contact the ESRD QIP team at esrdqip@cms.hhs.gov.