The Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the 2021 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Quality Incentive Program (QIP) on July 6. The proposed rule contains some of the nuts and bolts that run the Medicare ESRD program on the facility side. It contains numerous guardrails to protect kidney failure patients and provide them access to the best modalities.
You can learn more about the KCC Model of the AAKH initiative by joining a series of webinars being hosted by the Center for Medicare and Medicaid Innovation (CMMI). CMMI will be hosting a series of webinars to introduce the details of the CMS Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC) Model Options and review the application process, which closes on January 22, 2020. The webinars are:
After a long period of consultation with ASN and others in the kidney community, Department of Health and Human Services (HHS) Secretary Alex M. Azar, II, yesterday unveiled the four voluntary kidney care payment options of the Kidney Care Choices (KCC) Model that are a part of the Advancing American Kidney Health (AAKH) initiative. ASN President Mark E. Rosenberg, MD, FASN, calls the AAKH initiative “a true game changer.”
The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Look-Up Tool, yesterday on June 14th, to allow clinicians to view 2018 Merit-based Incentive Payment System (MIPS) eligibility and Alternative Payment Model (APM) Qualifying APM Participant (QP) data—in one place. Additionally, the look-up tool name was changed from the MIPS Participation Status Tool to the Quality Payment Program Participation Status Tool to reflect the changes CMS made.
The Kidney Care Choices (KCC) Model, also known as the “voluntary model”, is moving forward beginning April 1, 2021 – a delay from the original start date of January 1, 2021 – due to the Public Health Emergency (PHE). The Centers for Medicare & Medicaid Services (CMS) Innovation Center announced that in addition to delaying the start of the model, the agency will also provide a second window for applications in 2021 for new participants with a starting date for that group of January 1, 2022. Additionally, applicants approved for the April 1, 2021 start date will have the option to delay their start date to January 1, 2022 without penalty or having to reapply. Also covered in this announcement was an extension of the Comprehensive ESRD Care Model (CEC) until March 31, 2021, with financial adjustments for performance year 2020 due to COVID-19. The CEC created the ESRD Seamless Care Organizations (ESCOs) of which there are 33 nationally.
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule yesterday, November 26, 2018, that includes changes to Medicare Advantage and Part D. Medicare says its proposal will give Part D drug plans more power to negotiate with pharmaceutical companies, but some patient and provider groups say that it will reduce access and shift costs onto beneficiaries.
CMS said in its proposed rule that it would start allowing Part D plans to exclude a drug from the "protected" classes on their formularies if the increase in the drug's price is greater than inflation or if CMS determines that the drug is not a significant innovation over the original product. Current policy requires Medicare Part D plans to cover drugs in the following six categories:
The American Society of Nephrology (ASN) member, Jonathan Jaffery, MD, MS, MMM, is one of the five newest members who will serve on the Medicare Payment Advisory Commission (MedPAC). Dr. Jaffrey was appointed to serve on MedPAC by Gene L. Dodaro, Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), on May 30. At the same time, ASN announced that it has joined the Physicians’ Electronic Health Record Coalition (PEHRC), which is comprised of ASN and 25 other medical societiesrepresenting more than 600,000 physicians, who share information to support the use of health information technology (IT). ASN’s lead nephrologist in the coalition is Daniel E. Weiner, MD, FASN, and chair of the ASN Quality Committee.
Wednesday, July 10, the Trump administration will announce a new Department of Health and Human Services-wide (HHS) Comprehensive Kidney Care strategy. ASN and other kidney care groups have been working and meeting with Administration officials, including Secretary Alex M. Azar, II, all year providing input and recommendations for inclusion of in the new strategy.
The Trump Administration on Tuesday, June 19, unveiled the final rule allowing potentially millions of small businesses and self-employed workers to buy health-insurance plans exempt from many Affordable Care Act (ACA) consumer protections. However, plans will still be barred from discriminating against or charging more for individuals with pre-existing conditions. The American Society of Nephrology (ASN) is reviewing the details of the rule now.