Dialysis Facility Compare Star Ratings Draw First Challenge to CMS Quality Measures Under Data Quality Act
Skewed geographic distribution of star ratings demonstrates program’s flaws, says Dialysis Patient Citizens WASHINGTON, D.C. (Dec. 16, 2014) — Dialysis Patient Citizens has filed the first challenge to a CMS quality program under the Data Quality Act, contending that the agency’s Dialysis Facility Compare (DFC) star ratings methodology fails to satisfy federal requirements for objectivity and utility in presenting information to the public. The day after being served with the complaint, CMS conceded it should have conducted cognitive testing of this system on consumers, reversing a position the agency had defended for nearly four months. “We felt this challenge was necessary in light of CMS’ continued refusal to [...]
DPC’s Request for Correction complaint to CMS Regarding DFC Star Ratings
Attached is CCSQ’s courtesy copy of the Request for Correction we filed today under the Data Quality Act challenging the methodology to be used in the DFC Star Ratings. The Data Quality Act and the HHS Information Quality Guidelines promulgated pursuant to the Act have been in existence for approximately as long as CMS has collected and reported quality measures. Over the past decade, no stakeholder has ever filed a Request for Correction with CMS pertaining to quality measurements. We take no joy in being the first, but we feel that the circumstances surrounding the formulation of this program—the lack of [...]
Prior Authorization of Non-Emergency Ambulance Transportation to Begin for Dialysis Patients in New Jersey, Pennsylvania and South Carolina
The Centers for Medicare & Medicaid Services (CMS) will begin implementing a prior authorization demonstration program for non-emergent ambulance transport of dialysis patients in New Jersey, Pennsylvania and South Carolina. CMS believes using a prior authorization process will help ensure services are provided in compliance with Medicare coverage rules, specifically that ambulance providers in those states must obtain documentation from physicians prior to the beginning of service. The requirement does not apply to hospital-based ambulances. CMS is taking these actions in response to instances of fraud in those three states. For example, one Pennsylvania fraud scheme involved more than $3.6 [...]
New Dialysis Quality Rules May Bring Small but Noticeable Changes to Your Care
The Centers for Medicare and Medicaid Services (CMS) recently finalized the payment rule for the Medicare End Stage Renal Disease (ESRD) program for 2015. Payment rates will stay the same next year. However, changes to the Quality Improvement Program (QIP) system of "pay for performance" are intended to prioritize new aspects of care for ESRD patients; providers are graded on each element of the "QIP" and receive payment reductions if they don't meet Medicare's standard. This means that providers are expected to add emphasis to these new areas in their interactions with patients. Here are some of the new areas being [...]
CMS Responses to Questions and Comments about the Dialysis Facility Compare Star Rating System
CMS thanks the community for their comments and questions about the DFC Star Rating System. All comments have been given serious consideration. This document provides responses to the questions and issues raised by the ESRD community. CMS believes that the Star Rating System will empower consumers with additional quality information. It will also encourage providers to continuously achieve higher quality care. With future releases and enhancements to the DFC website, we will continue fostering an open dialogue to facilitate providing better care for all patients receiving chronic dialysis. We look forward to working with the ESRD community over the coming months [...]
Response Memo: FAQs Regarding Medicare and the Health Insurance Marketplace
To: James Canavan, Center for Medicare, Centers for Medicare & Medicaid Services Spencer Manasse, Center for Consumer Information and Insurance Oversight, CMS Vicki Gottlich, Administration for Community Living Gene Coffey, Center for Medicaid and CHIP Services, CMS Janet Miller, Office of Communications, CMS Sharon Donovan, Medicare-Medicaid Coordination Office, CMS Re: Comments on “Frequently Asked Questions Regarding Medicare and the Marketplace” We appreciate that the Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) arranged a July meeting for beneficiary advocates to discuss our questions and concerns related to beneficiary transitions from coverage options created under [...]
Statement of Dialysis Patient Citizens on CMS Announcement of Delay in Implementing Star Ratings for Dialysis Facility Compare Website
Today, Dialysis Patient Citizens received a notice from CMS announcing a three-month delay in implementing its Star Ratings Program for the Dialysis Facility Compare website. Contrary to CMS’ announcement, a delay alone is not responsive to the concerns expressed by stakeholders and certainly not to those expressed by DPC. While CMS said it was “partnering with the ESRD community,” it has instead declined to consider input on how to design patient-friendly ratings, and ignored DPC’s requests to see consumer testing materials and the geographic distribution of star assignments. We believe that CMS’ methodology which gives thirty percent of dialysis facilities the [...]
DPC Submits Comments on this Year’s Medicare ESRD Payment Rule
In late August, DPC submitted comments to the Center for Medicare and Medicaid Services (CMS) on its payment-setting rule for dialysis facilities in 2015. The rule keeps next year’s payments for dialysis level with this year’s, following a mandate from Congress, but makes some changes to the ESRD Quality Incentive Program (“QIP”) that reduces payments to the lowest-performing facilities. Here are highlights of proposed changes along with DPC’s commentary: Patient Satisfaction Survey Scores To Count Toward QIP Payment Reductions: For several years now, dialysis facilities have administered the “CAHPS” survey of patient experience to patients. However, under current regulations, dialysis facilities [...]
DPC to Host Regional Meetings
DPC is excited to announce the beginning of a new program to further engage kidney disease patients through education and advocacy. For the first time ever, DPC is hosting four regional meetings in sites around the country to bring dialysis patients together to engage on issues important to their care and well-being. The inaugural locations for these regional meetings are as follows: Detroit, Michigan; Seattle, Washington; Houston, Texas and New York, New York. We have partnered with the American Psychological Association to provide an informative and engaging session on the importance of having good mental health as a kidney disease [...]