CHA News Article

CMS Proposes Updates to ESRD PPS for CY 2015

The Centers for Medicare & Medicaid Services (CMS) estimates payments to hospital-based end-stage renal disease (ESRD) facilities will increase by 0.5 percent, and by 0.3 percent in freestanding facilities, as a result of updates proposed in the calendar year (CY) 2015 ESRD prospective payment system proposed rule. CMS projects that the ESRD bundled market basket adjusted for the multifactor productivity update would have been 1.6 percent; however, the Protecting Access to Medicare Act of 2014 requires no increase in the CY 2015 ESRD payment update. Proposed updates to the outlier policy, Core Based Statistical Areas, and labor-related share account for the overall projected payment increase of 0.3 percent for CY 2015.

CMS also proposes updates to the ESRD Quality Incentive Program (QIP) for payment years 2017 and 2018. Under the ESRD QIP, facilities that do not achieve a minimum total performance score with respect to quality measures established in regulation receive a reduction in their payment rates under the ESRD PPS. This rule also addresses issues related to the coverage and payment of durable medical equipment, prosthetics, orthotics, and supplies. Comments on the attached proposed rule are due Sept. 2.