CMS retains 12% cut in drug payments for ESRD care, approves new QIP measur
Nov 25, 2013 — The Centers for Medicare and Medicaid Services issued its much-anticipated final rule on Friday that updates payment rates for 2014 for dialysis facilities paid under the end-stage renal disease Prospective Payment System (PPS). The agency also approved final changes to the Quality Incentive Program for performance year 2014, which will impact dialysis clinic payments in 2016.
CMS released a proposed rule in July that called for a 12% reduction in payments for injectable drugs based on a 30%+ drop in utilization––primarily in the prescribing of anemia drugs––from 2007 to 2012. The agency proposed to temper the cut with a 2.6% payment increase for 2014 based on the annual Medicare market basket review of costs of providing care to dialysis patients.
Despite over 1,000 comments protesting the proposed cut by the dialysis industry, patients, renal association groups, and even members of Congress, the agency decided to keep the 12% reduction in the drug utilization adjustment .