CMS proposes 1.6% increase in payment for dialysis facilities
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Key takeaways:
- CMS has released a proposed rule that would increase the Medicare bundled payment rate by 1.6% for 2024.
- The proposed rule also updates measures for the ESRD Quality Incentive Program.
CMS has released a proposed rule that would increase the bundled payment rate for dialysis treatments by 1.6% in 2024 – about half of the increase that clinics received for 2023.
The rule also proposes updates to the payment rate for renal dialysis services furnished by facilities for patients with AKI and updates requirements for the End-Stage Renal Disease Quality Incentive Program.
The 1.6% increase would result in a new payment per treatment rate of $269.99, an increase of $4.42 more than the current 2023 base rate of $265.57.
Dialysis providers, led by the Renal Healthcare Association, lobbied Congress last year about increases in the treatment rate that they said were inadequate.
“A mere 3% increase to the base rate for [calendar year] 2023 is woefully inadequate in this time of economic and staffing instability,” Caprice Vanderkolk, MS, RN, BC-NE, president of the Renal Healthcare Association, wrote in the letter to Congress in December 2022. “With absent action from Congress, access to care and the quality of care for individuals relying on Medicare for their dialysis services will be jeopardized.”
The ESRD Prospective Payment System has provided a bundled, per-treatment payment to dialysis facilities since 2011 that includes all renal dialysis services furnished for outpatient maintenance dialysis, including drugs and biological products (except for oral-only ESRD drugs until 2025).
The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/2023-13748/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis.
References:
Fact sheet: Calendar year 2024 end-stage renal disease (ESRD) prospective payment system (PPS) proposed rule (CMS-1782-P). Published June 26, 2023. Accessed June 27, 2023.
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