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Medicare Payment Changes to Support Innovation and Increased Access for Dialysis in the Home Setting

Dear Members,


On July 6, 2020, Trump Administration took steps to support access to home dialysis through the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare End-Stage Renal Disease (ESRD) Prospective Payment System (PPS).


CMS is proposing that certain new and innovative equipment and supplies used for dialysis treatment of patients with ESRD in the home would qualify for an additional Medicare payment.


These proposed changes would encourage the development of certain new and innovative home dialysis machines that would give beneficiaries more dialysis treatment options in the home that can improve their quality of life.


CMS to improve care for beneficiaries with kidney disease including:

  • The proposed ESRD Treatment Choices (ETC) Model that would encourage greater use of home dialysis and kidney transplants for Medicare beneficiaries with ESRD in order to preserve or enhance their quality of care while reducing Medicare expenditures,

  • The Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC) Options of the Kidney Care Choices (KCC) Model that will test whether new care delivery and Medicare payment options can improve the quality of care and reduce the total cost of care for patients with kidney disease.

  • Refinements to eligibility for the transitional drug add-on payment adjustment (TDAPA) under the ESRD PPS to better target the additional payment to innovative renal dialysis drugs and biological products based on the Food and Drug Administration’s (FDA’s) New Drug Application Classifications.

For more information:

https://www.cms.gov/newsroom/fact-sheets/end-stage-renal-disease-esrd-prospective-payment-system-pps-calendar-year-cy-2021-proposed-rule-cms


https://www.federalregister.gov/public-inspection/current






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