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Payment Matters: CMS Proposes ESRD PPS for 2013, and Bad Debt Reductions for All

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CMS has released the 2013 proposed regulation for the End Stage Renal Dialysis Prospective Payment System (ESRD PPS). In that rule CMS proposed a payment rate increase in the per treatment reimbursement, a 35% reduction in allowable ESRD bad debt amounts to be implemented over 3 years, and an update to the ESRD Quality Improvement Program (ESRD QIP). The proposed rule also implements reductions in bad debt reimbursements for all other health care providers, suppliers and other cost-reporting entities required by the Middle Class Tax Extension and Job Creation Act of 2012. Comment on the proposed regulations will be accepted through August 31, 2012.

ESRD Provisions -

CMS estimated that the proposed 2013 payment rates will increase ESRD facility reimbursement by $300 million nationwide, or approximately a 3.0% increase over 2012. CMS also anticipated that the ESRD QIP, which reduces reimbursements to ESRD facilities that do not provide quality improvement data, will reduce reimbursements by $8.5 million in 2013.

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Published In: Administrative Law Updates, Health Law Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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