CMS will phase in cuts to dialysis providers over three to four years, meaning overall payments for 2014 will remain the same, according to a final rule released Friday.
As part of the last-minute "fiscal cliff" deal, CMS proposed $4.9 billion in savings from recalculating bundled payments for dialysis providers. The proposal came in response to a Government Accountability Office report that found Medicare had overpaid for end-stage renal disease treatment by relying on outdated drug-use trends. Specifically, Medicare relied on 2007 treatment protocols for anti-anemia drugs to calculate payments, though their use has declined significantly in recent years due to safety concerns.
The agency recommended the 9.4% cut in July, but industry advocates said such a cut would force smaller operators out of business and decrease patient care in rural areas.
Friday's final rule authorized a 50% increase to home dialysis training payment adjustments and also reduced Medicare payments by 1.05%, according to Reuters.
According to the Wall Street Journal, the base rate per payment in 2014 will remain relatively unchanged at $239.02, a 0.55% decrease from the 2013 base rate of $240.36. In 2015, the rate will remain the same as 2014.
In total, according to documents from CMS, the payment rate will decrease by about $29 over the next three to four years (Beasley/Burger, Reuters, 11/22; Kutscher, Modern Healthcare, 11/22 [subscription required]; Walker, Wall Street Journal, 11/22).