CHA News Article

CMS Issues Final Rule on ESRD, DMEPOS Payment Policies for CY 2015

The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule updating payment rates for the calendar year (CY) 2015 end-stage renal disease (ESRD) prospective payments system. Under the final rule, CMS estimates payments to hospital-based ESRD facilities will increase by 0.5 percent, and by 0.3 percent in freestanding facilities, compared to CY 2014. CMS also finalized updates to the ESRD Quality Incentive Program for payment years 2017 and 2018 and has published a fact sheet outlining its finalized quality provisions.

The final rule also includes provisions for the methodology for making national price adjustments based on information gathered from the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. In comments, CHA expressed concern about the effects of those payment methodologies on access to DME for Medicare patients. In the final rule, CMS acknowledged the need to closely monitor the impact on access. However, it did not find it necessary to adopt an additional methodology to account for access problems. CMS indicated it could address the matter in future rulemaking.