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July 13, 2018

CMS proposes 1.7% payment boost for dialysis providers

Daily Briefing

    CMS on Wednesday proposed a rule that would update Medicare policies and payments for the End-Stage Renal Disease (ERSD) program and aims to simplify Medicare's Durable Medical Equipment Prosthetics, Orthotics, and Supplies Bidding Program.

    Proposed rule details

    CMS in the rule proposed raising the ESRD prospective payment system base rate for 2019 to $235.82, up $3.45 from the 2018 base rate of $232.37.

    CMS said that change, along with other technical updates to its payment methodology, would result in an overall increase of 1.7%, or $190 million, in Medicare payments for ESRD facilities in 2019, when compared with 2018. Hospital-based ESRD facilities would see a 1.8% increase in total payments, while freestanding facilities would see total payments rise by 1.7%, according to CMS.

    In total, CMS projected Medicare will pay about $10.6 billion to about 7,000 ESRD facilities in 2019 for costs associated with providing chronic maintenance dialysis services.

    In addition, CMS in the rule proposed changing its bidding system for durable medical equipment. Under the current system, prices for powered wheelchairs and their accessories are set by suppliers' bids, Modern Healthcare reports. However, according to Modern Healthcare, CMS proposed implementing lead item bidding, under which suppliers can bid on prices for the power wheelchair, but CMS would set prices for accessory items based on a fee schedule (Dickson, Modern Healthcare, 7/11; Morse, Healthcare Finance News, 7/11; CMS factsheet, 7/11).

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