CMS Proposes 2020 Policy and Payment Rate Changes for ESRD Facilities, Kidney Care Community Responds

On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (CMS 1713-P) to update payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2020. This rule also:

  • proposes updates to the acute kidney injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities to individuals with AKI
  • proposes changes to the ESRD Quality Incentive Program (QIP)
  • includes requests for information on data collection resulting from the ESRD PPS technical expert panel, on possible updates and improvements to the ESRD PPS wage index, and on new rules for the competitive bidding of diabetic testing strips
  • proposes a methodology for calculating fee schedule payment amounts for new durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) items and services and making adjustments to the fee schedule amounts established using supplier or commercial prices if such prices decrease within 5 years of establishing the initial fee schedule amounts

On August 20, 2019, the Medicare Learning Networking will hold a call to review components of the proposed rule and the process for submitting comments. Comments on the proposed rule are due to CMS by September 27, 2019.

Response to Proposed Rule