On November 1, the Centers for Medicare and Medicaid Services (CMS) published a final rule that implements updates and revisions to the ESRD Prospective Payment System (PPS) for calendar year 2018, and sets forth requirements for the ESRD Quality Incentive Program (QIP) for payment years 2019 through 2021. CMS also released an accompanying fact sheet. In the rule, CMS:

  • Finalized a 0.5 percent pay rate increase for dialysis facilities for calendar year 2018.
  • Finalized its proposal to shorten and simplify the Performance Score Certificate (PSC) and reduce the amount of information beneficiaries will have access to on the PSC (AKF had opposed this proposal in our comment letter on the proposed rule).
  • Finalized ESRD QIP measures for payment year 2021 that address anemia management, dialysis adequacy, vascular access type, patient experience of care, infections, mineral metabolism management, safety, pain management, depression management, and hospital readmissions. CMS is replacing the two existing Vascular Access Type (VAT) measures with newly National Quality Forum (NQF)-endorsed Hemodialysis Vascular Access: Standardized Fistula Rate Clinical Measure and the Hemodialysis Vascular Access: Long-Term Catheter Rate Clinical Measure. CMs is also revising the Standardized Transfusion Ratio (STrR) Clinical Measure to align it with specification updates endorsed by NQF.