Most dialysis costs are covered by Medicare regardless of the age of the patient. Since Medicare reimburses for the majority of dialysis treatments they have rules and standards that dialysis providers must follow to ensure patient health and safety is the ultimate priority for providers.
DPC comments on Medicare’s Physician Fee Schedule
On August 24, 2010 DPC submitted comments to the Centers for Medicare and Medicaid Services (CMS) thanking them for including kidney disease education sessions in the list of Medicare covered health services. DPC also provided comments on proposed Medicare regulations that would require physicians to see their home dialysis patients in person at least once per month.
Read DPC’s letter to CMS
Home Hemodialysis Work Group Adequacy Report Recommendations
DPC joins with other organizations to request CMS use a weekly or standardized Kt/V be used to measure and report dialysis adequacy for home hemodialysis patients.
Recommendations
Centers for Medicare and Medicaid Services (CMS) Releases Final Rule on the New Bundled Payment Structure
Learn more about the Bundled Payment Structure
CKD IV Education for Medicare Beneficiaries and Cuts to Vascular Access Centers
In another proposed rule CMS is seeking input is on the creation of a reimbursement program to educate patients, who have stage four of kidney disease, before they reach dialysis. In the same proposed rule known as the CMS-1413-P: Proposed Rule for Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2010 CMS is looking to cut reimbursement to Vascular Access Centers by 22.5%. Cuts to these centers could cause many of them to close leaving many patients with no other option but to be admitted to the hospital to have problems with their fistulas, grafts or catheters fixed. DPC submitted comments on these two important issues.
US Government Accountability Office - Report to Congreessional Committees, May 2009
End Stage Renal Disease: CMS should monitor effect of bundled payment on home dialysis utilization rates.
GAO Report
Centers for Medicare and Medicaid Services (CMS) Implementation of the "ESRD Bundle"
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As CMS works to implement their new payment system for dialysis care, DPC is following the issue closely and providing advise on the best way to implement the program for patients. CMS is expected to put out a proposed plan also known as a “proposed rule” the public will have an opportunity to comments and DPC will ensure dialysis patients are heard in this process. Learn more about how this issue impacts you by reading our letter to Dr. Barry Straube at CMS. We will send out more information on how you can directly participate in the comment process as soon as the rule is released.
Improved Patient Safeguards
On April 3, 2008, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that establishes new Conditions for Coverage (CfCs) that dialysis facilities must meet to be certified under the Medicare program. The final rule reflects advances in dialysis technology and standard care practices since the requirements were first issued in 1976.
Most of these rules go into effect October 14, 2008, but some conditions will not be in
effect until February 2009.
Click here for a summary of the rules that will impact dialysis patients the most.
ESRD Networks
Under the direction of CMS, the End-Stage Renal Disease (ESRD) Network Program consists of a national network of 18 ESRD Networks, responsible for each U.S. state, territory, and the District of Columbia. ESRD Networks service geographic areas based on the number and concentration of ESRD beneficiaries.
ESRD Networks work with consumers and ESRD facilities and other providers of ESRD services to refine care delivery systems to make sure ESRD patients get the right care at the right time. http://www.esrdnetworks.org
The Program's responsibilities include:
- Assuring the effective and efficient administration of benefits
- Improving quality of care for ESRD patients
- Collecting data to measure quality of care
- Providing assistance to ESRD patients and providers
- Evaluating and resolving patient grievances
ESRD Special Study:Delivery of Dialysis Treatment Within the Long-Term Care Facility
The following report conducted by ESRD Networks 9 and 10 provided recommendations to on best practices for providing dialysis services in long-term care facilities.
Best Practices
