CHA News Article

ESRD Final Rule for CY 2016 Issued

The Centers for Medicare & Medicaid Services (CMS) last week issued the attached final rule for the calendar year (CY) 2016 end-stage renal disease (ESRD) prospective payment system. CMS estimates that the updates for CY 2016 will increase the total payments to both hospital-based and freestanding ESRD facilities by 0.2 percent compared with CY 2015, down from an estimated 0.5 percent increase for hospital-based ESRD facilities in the proposed rule. The final rule includes updates to the case mix payment adjustments based on more recent data, as required by the American Taxpayer Relief Act of 2012. The final rule also updates the ESRD quality incentive program, including the addition of one new measure and removal of four measures for payment year 2019. CMS also finalizes a clinical measure, required by the Protecting Access to Medicare Act of 2014, specific to conditions treated with oral-only medications. The final rule is effective for renal dialysis services on or after Jan. 1, 2016.