Final Physician Fee Rule Includes Wins for Kidney Community

On Halloween Eve 2014, CMS released the 2015 Physician Fee Schedule final rule, finalizing several important victories for ASN and other advocates in the kidney community.

A top ASN priority, also supported by other stakeholders, was to modify the billing rules to allow nephrologists to bill the full month of care when a home dialysis patient has been hospitalized during that month. CMS finalized the proposal it laid out in the proposed rule that would allow nephrologists who complete monthly assessment of home dialysis patients and at least one face-to-face patient visit to bill for the full monthly MCP code for home dialysis patients who are hospitalized that month. Previously, nephrologists had to bill the per diem code in months when their home dialysis patients were hospitalized. ASN and other advocates, including the Home Dialysis Alliance and Kidney Care Partners, supported this change,.

Also in the final rule, CMS addressed concerns raised by ASN and others in the Continuing Medical Education (CME) community that physicians attending certified CMS programs like ASN Kidney Week could get unfairly reported in the Open Payments program. The Open Payments program is an online federal initiative to increase transparency regarding physicians’ financial relationships with industry, such as gifts and travel.

CMS established reporting rules that specifically exclude CME payments from the Open Payments program, including speaker-related payments and tuition support for attendees, so long as they are not directed by a commercial supporter.

Although CMS does not yet have the legal authority from Congress to designate patients’ homes as qualifying telehealth sites, ASN has and will continue to encourage both CMS and Congress to consider the potential benefits of adding the monthly capitation payment (MCP) services for home dialysis patients to the Medicare telehealth list as federal statute regarding telehealth sites evolves. This could enable more patients to consider dialysis at home, and reduce the travel burden for both patients and providers. CMS did note that it could pilot telehealth MCP care through its Innovation Center, opening up a new advocacy angle for 2015.

For more information on the final rule, please visit ASN’s policy webpage at http://www.asn-online.org/policy/