Dialysis Reimbursements Stabilized by Protecting Access to Medicare Act

This week President Obama signed the Protecting Access to Medicare Act, which contained some provisions favorable to dialysis patients. The primary purpose of the legislation was to stabilize Medicare payments to physicians, but Congress also used the opportunity to stabilize reimbursements to dialysis facilities. A large cut that had been scheduled to take effect in 2016 has been replaced by smaller, fixed-amount cuts that afford providers more certainty about revenues in coming years. This new payment formula will encourage providers to renew expiring leases on dialysis facilities and continue to invest in improved kidney care infrastructure.

Another provision further delays addition of oral-only drugs to the End Stage Renal Disease (ESRD) Bundled Payment. These drugs, which include phosphate binders and calcimimetics, will continue to be received from your pharmacy until 2024.

The legislation also enacted a recommendation from the Medicare Payment Advisory Committee that the Medicare agency audit the cost reports submitted by dialysis facilities. This serves a dual purpose of ensuring that cost reports are reliable and reminding Medicare officials that reimbursements must be sufficient to cover the entire cost of providing care at an efficient dialysis facility.

DPC is pleased by this positive development for kidney care. This could not have happened without the continued visibility of dialysis patients, through your calls, letters and visits to your representatives in Congress. 

 

Dialysis Patient Citizens
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Washington, DC 20005

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Email: dpc@dialysispatients.org