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Medicare payment for dialysis bundled under new rule

NEWS IN BRIEF — Posted Aug. 2, 2010

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The Centers for Medicare & Medicaid Services issued a final rule July 26 that significantly changes how Medicare pays for dialysis services for beneficiaries who have end-stage renal disease.

Currently, Medicare pays for certain dialysis services under a composite, or partial bundled, rate. The new prospective payment system provides a single bundled, case-mix-adjusted payment for services such as dialysis treatments and supplies, certain end-stage renal drugs, and clinical laboratory tests beginning on Jan. 1, 2011. The final rule sets a base payment rate of $229.63 for each dialysis treatment.

In addition, CMS issued a proposed rule that would establish a new quality incentive program for dialysis facilities by linking payments to performance standards. Three quality measures will be used in the initial implementation -- two that will reflect whether patients are receiving appropriate treatments for anemia, and a third that measures patients' urea reduction ratios.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2010/08/02/gvbf0802.htm.

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