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The Centers for Medicare & Medicaid Services (CMS) is conducting its 2018 Burdens Associated with Reporting Quality Measures Study, as outlined in the Quality Payment Program (QPP) Year 2 final rule – 2018 is the QPP’s second year of implementation. Last year, 2017, was a transition year for the new program. As the QPP matures and the reporting requirements increase, it is important that nephrologists participate in this study to ensure their reporting burdens are registered. The American Society of Nephrology (ASN) Quality Committee and ASN Policy staff depend on your participation to advance regulatory policies that are beneficial and, when possible, less burdensome to nephrologists.
Telehealth Waiver
New coverage for telehealth services is on the way for Comprehensive ESRD Care Models, ESCOs, and the patients they serve. The Centers for Medicare and Medicaid Services (CMS) have added a telehealth waiver for their use effective Oct. 1, 2018.
The American Society of Nephrology (ASN) and the Alliance for Home Dialysis have been discussing the need for this waiver with the Centers for Medicare and Medicaid Innovation (CMMI) for over a year. As reported in Kidney News Online earlier this year, ASN and members of the Alliance have been advocating for a broader array of telehealth services for patients with kidney failure to be covered by Medicare for several years now – both on Capitol Hill and with CMS.
The Centers for Medicare and Medicaid Services (CMS) have incorporated a new “MIPS Participation Status” function on the Quality Payment Program (QPP) website. To find out whether you need to participate in the Merit-based Incentive Payment System (MIPS) during the 2018 performance year, just enter your National Provider Identifier, or NPI.
After two years of diligent efforts by the American Society of Nephrology (ASN) and other members of the Alliance for Home Dialysis, the provisions of the CHRONIC Care Act were signed into law after being included in the two-year budget agreement passed in February. The CHRONIC provisions authorize, among other items, a home dialysis patient’s monthly clinical visits to be conducted via telehealth with the home as an originating site. ASN and others supported the inclusion of telemedicine provisions in the recent congressional budget deal to pave the way for greater use of the technology and to boost access to care while reducing costs.
While the legislative success was widely applauded by ASN and other members of the Kidney Community, that was just part of the story. The other part has been playing out on the regulatory side in a choreographed dance between ASN and peer societies on one side and with the Centers for Medicare and Medicaid Services (CMS) on the other. Perhaps more accurately, the band was warming up and the participants were making their introductions before CHRONIC became law, but now the ball is in full swing.
Before Thanksgiving, the House of Representatives passed H.R. 1, the Tax Cuts and Jobs Act, by a vote of 227 to 205. The vote largely fell along party lines, with no Democrats voting for the bill. The House bill has several provisions of concern to the American Society of Nephrology (ASN), including one that could devastate the pipeline of future scientists.
“The already strained kidney science and care workforce—particularly PhD scientists—would be decimated by eliminating the deduction for graduate education and by PAYGO1 cuts to student aid administration program, jeopardizing any hope of future discoveries to cure kidney diseases. Every effort should be taken to encourage, not discourage, the next generation of scientists from pursuing their studies,” wrote ASN President Eleanor D. Lederer, MD, FASN, in a November 22, 2017 memorandum to House and Senate leaders.
Recently, there have been some very troubling developments involving the Medicare Administrative Contractors – the MACs – that has ASN and other members of the kidney community highly concerned. The MACs, within a short window of time, have announced plans to limit reimbursement for dialysis that occurs more than three times per week exclusively to patients that meet specific acute conditions. The conditions have been outlined in a draft Local Coverage Determination (LCD). These draft LCDs propose that any claim linked to a Plan of Care that includes dialysis treatments occurring more than three per week—for any chronic condition or acute condition not included on the list—will be denied.
American Society of Nephrology (ASN) President Eleanor D. Lederer, MD, FASN, wrote to Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Charles E. Schumer (D-NY) today expressing ASN’s strong objections to the Graham-Cassidy health care proposal under consideration in the US Senate this week.
The Quality Payment Program Hardship Exception Application for the 2017 transition year is now available on the Quality Payment Program website .
The Centers for Medicare & Medicaid Services (CMS) released the Quality Payment Program (QPP) proposed rule for 2018 on Tuesday, June 20. While we are only beginning to go through the proposed rule, all 1,058 pages, it does appear that CMS is concerned about the burden of participating in the program on small practices leading to a significant proposed rise in the low-volume threshold.
The Trump administration unveiled a proposed FY 2018 budget on Tuesday, May 23, that would cut funding for the National Institutes of Health (NIH) by $7 billion, about a 23 percent reduction from current levels. In a statement from American Society of Nephrology (ASN) President Eleanor D. Lederer, MD, FASN, the society denounced the budget and maintained that NIH funding cuts of the level proposed could disrupt medical research, impede the development of innovative treatments for the 40 million Americans living with kidney diseases, and ultimately costs more money for the treatment of kidney diseases and failure.
