ARTICLE
14 December 2011

Dialysis Reimbursement Changes Announced for 2012

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CMS recently announced that on average the bundled base payment for dialysis services under the prospective payment system (PPS) that first became effective in 2011 will increase in 2012 by 2.1% over the reimbursement rates in effect for 2011.
United States Food, Drugs, Healthcare, Life Sciences

CMS recently announced that on average the bundled base payment for dialysis services under the prospective payment system (PPS) that first became effective in 2011 will increase in 2012 by 2.1% over the reimbursement rates in effect for 2011. This increase is based on the CMS legally required annual update of PPS for dialysis services based on any changes in the market basket of dialysis services costs and any productivity adjustments during the period being evaluated.

Along with this change, CMS announced the quality improvement performance standards that will apply for 2012. If in 2012 (the baseline year for 2014 payments), a dialysis provider fails to meet these standards (which are part of the ESRD Quality Incentive Program, called QIP), CMS will reduce by up to 2% the payments during 2014 to the dialysis provider from the amount that would be otherwise payable to the provider. The QIP changes are significant in that they require tracking during 2012 of additional clinical measures by dialysis providers.

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