Could Deemed Status Become Reality for the Dialysis Industry?

Full access

Late 2017 found a push in the Senate to pass a companion bill to H.R. 3166, which would allow “deemed status” of ESRD facilities. Deemed status allows use of a survey by an accreditation agency to substitute for a survey by a state agency in outpatient dialysis facilities and could speed up the accreditation process.

The original law extending Medicare coverage to patients with ESRD prohibited the Centers for Medicare & Medicaid Services (CMS) from granting deemed status to accreditation agencies. If the Senate passes the companion bill and it is signed into law by the President, accreditation agencies will be able to apply for deemed status for surveys of outpatient dialysis facilities.

The dialysis industry has pushed for this change primarily to expedite initial surveys. Because CMS categorizes initial surveys as low priority (“Tier 3” for ESRD), there can be a long wait for an initial survey—as long as 28 months in some states. Because a new facility will not be reimbursed for the care they deliver to Medicare patients until the facility has successfully passed this survey, that wait can be very painful. If the bill becomes law, facilities will be able to pay accreditation organizations that achieve deemed status for ESRD to conduct their initial surveys, which should shorten the wait for Medicare certification and reimbursement.