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To potentially earn a positive payment adjustment under MIPS (Merit-based Incentive Payment System), send in data about the care you provided and how your practice used technology in 2017 to MIPS by the March 31, 2018, deadline. In order to earn the 5% incentive payment by significantly participating in an Advanced APM, just send quality data through your Advanced APM.

CMS Web Interface users (groups with 25 or more clinicians, including APM entities) have a shorter timeframe to submit quality data, as the submission window for this method closes March 16, 2018, at 8 p.m. Eastern Time. Go to qpp.cms.gov

David White

Telehealth and telemedicine reimbursement received big boosts in the two-year budget deal signed into law by President Donald Trump on February 9, 2018, with one senator saying the law does more for Medicare coverage of telehealth than any past legislation.

The budget deal included parts of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act advocated for by the American Society of Nephrology (ASN) and fellow members of the Telehealth/Remote Monitoring Coalition. Targeted at Medicare’s telehealth and telemedicine reimbursement rules, the new law:

■ adds the patient’s home, without geographic restriction, to the list of originating

David White

The American Society of Nephrology’s (ASN) Quality Committee has its hands full in 2018. First, the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act (MACRA) enters its second year after a very limited implementation as a transition year in 2017. Foremost, the QPP is beginning to calculate a “cost” section in physician scores and will need to be monitored closely by ASN and other medical societies for unintended consequences. Equally important are efforts to include acute kidney injury (AKI) in the End-Stage Renal Disease Prospective Payment System and Quality Incentive Program (PPS/QIP) and increase access

David White

2018 is shaping up to be the year for designing and proposing integrated care models for testing by the Centers for Medicare & Medicaid Services (CMS). There are three major factors driving this trend:

Physician-Focused Payment Model Technical Advisory Committee (PTAC).

Request for Information (RFI) by the Centers for Medicare and Medicaid Services Innovation Center.

Perception that the train is leaving the station.

With further examination of these three factors, it becomes clearer how closely tied they are to one another.

PTAC

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) created new pathways for the Medicare program to

Keep an eye on the Quality Payment Program (QPP), created by the Medicare and Chip Access and Reauthorization Act of 2015 (MACRA), as the QPP enters its second performance year in 2018. The QPP is subdivided into two broad payment tracks: risk-bearing alternative payment models (APMs), such as downside risk Accountable Care Organizations (ACOs); and the Merit-Based Incentive Payment System, or MIPS, which aggregates scores across four domains to adjust payments based on performance. Between those two options is an important hybrid track for ACOs and participants in other alternative payment models that do not accept downside risk, called MIPS-APMs.

Keep an eye out in 2018 for Congress and the Administration to once again target research and health funding for FY 2019 with deep cuts proposed at both the discretionary and mandatory level. A year ago, President Trump set the tone of federal budget negotiations for FY 2018 with the introduction of his “skinny budget.” In a measure strongly condemned by then-ASN President Eleanor Lederer, MD, FASN, shortly after its introduction, the administration proposed deep cuts to funding for the National Institutes of Health, as well several other health programs.

In 2017, Congress listened to ASN’s strong stance against the

Innovation in kidney care promises to be a significant theme in the kidney community in 2018, and it is hoped, well beyond. At ASN Kidney Week 2017, Department of Health and Human Services (HHS) Chief Technology Officer Bruce D. Greenstein announced HHS’ commitment to launching a “KidneyX Innovation Accelerator” in 2018.

Although dialysis is a remarkable and life-saving technology, compared to other fields of medicine, nephrology has seen relatively few transformative new drugs or other therapeutics. Although kidney diseases are among the most complex, in part the relative dearth of innovation is due to perceptions of the market.

Angel investors,

David White

Multiple deadlines are available in December to voice your opinion with the Medicare Administrative Contractors (MACs) regarding their announced plans to limit reimbursement for dialysis that occurs more than three times per week exclusively to patients who meet specific acute condition requirements.

Seven MACs covering eight jurisdictions (WPS, Novitas Jurisdiction H, Novitas Jurisdiction J, NGS Jurisdiction K, NGS Jurisdiction 6, Noridian Jurisdiction E, Noridian Jurisdiction F, and First Coast, Palmetto, CGS), covering over half of the country, released nearly identical draft Local Coverage Decisions implementing restrictive guidance related to more frequent dialysis.

Within a very narrow timeframe, the MACs separately

Zachary Kribs

Advocates from the American Society of Nephrology (ASN) and 21 other kidney and transplant health care organizations met with nearly 100 members of Congress or their staff during the third perennial Kidney Community Advocacy Day on September 19, 2017 (Table 1). A total of 75 advocates urged Congress to continue its historic support of research funding for the National Institutes of Health (NIH) and to cosponsor and pass the Living Donor Protection Act (H.R. 1270), no-cost legislation that would eliminate barriers to living donation and increase access to transplants.

The Capitol Hill visits were part of an ongoing

David White

Quality and value care reimbursement: Where is it going in the next couple of years? There has been a great deal of talk and action to move health care from volume-based to value-based reimbursement. Most notable has been the creation of the Quality Payment Program (QPP) to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and replace the Sustainable Growth Rate (SGR). The program began this year with Medicare designating 2017 as a transition year with Merit-based Incentive Payment System (MIPS) clinicians getting to “pick your pace.” For 2017, the first year, clinicians are only required to