Final ESRD Payment and Quality Rule Released


On Friday, November 22, 2013, the Centers for Medicare and Medicaid Services (CMS) released a rule finalizing changes to the Medicare End-Stage Renal Disease (ESRD) Program, including a 12% cut to dialysis payments, which will be phased in over 3 to 4 years. There will be no changes to current reimbursement levels in 2014 and 2015.

Congress mandated CMS to reduce dialysis payments due to decreases in drug utilization, and the agency first proposed the 12% cut in July 2013. ASN and other kidney community stakeholders raised concerns about potential deleterious effects on access to and quality of care for the most vulnerable patients— including those in rural and inner-city environments—that a cut of that magnitude could create. ASN advocated that CMS phase in any cut to dialysis payment over 4 years, allowing providers to ensure continued access to care and for CMS to monitor any adverse consequences.

CMS also increased payments for home dialysis training by 50%, advancing a longstanding ASN policy goal, and implemented many of ASN’s recommendations for the ESRD Quality Incentive Program. Visit or follow @ASNAdvocacy for more information on the ESRD final rule.