News & Analysis as of

Final ESRD PPS Rule to Boost Overall Medicare Payment by $10 Million in CY 2016

On November 6, 2015, CMS published its final rule to update the Medicare end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2016. CMS estimates that the rule will increase overall Medicare...more

CMS Adopts ESRD PPS and QIP Final Rule for Dialysis Services

On November 6, 2015, the Centers for Medicare and Medicaid Services (CMS) published the final rule regarding the end-stage renal disease (ESRD) prospective payment system (PPS) for renal dialysis services furnished to...more

Also In The News - Health Headlines - November 2015

CMS Publishes Medicaid Access Final Rule – CMS published a Final Rule in the Federal Register today, November 2, 2015, that implements a process for states to determine whether Medicaid payments satisfy what is known as the...more

Mississippi CON Report

I. September 2015 – Mississippi Certificate of Need Meeting - During the September 24, 2015, Certificate of Need meeting, Dr. Mary Currier, State Health Officer, concurred with the health and planning staff analysis...more

Congress Wows With Medicare Telehealth Parity Act of 2015, But Will It Succeed?

Rep. Mike Thompson (D-CA) and co-sponsors Rep. Gregg Harper (R-MS), Rep. Diane Black (R-TN), and Rep. Peter Welch (D-VT) announced, on July 7, 2015, the introduction of the Medicare Telehealth Parity Act of 2015,...more

Health Care Update - July 2015

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

CMS Releases ESRD PPS Proposed Rule

On June 26, 2015, CMS released a Proposed Rule to increase payments by 0.3% for end-stage renal disease (ESRD) care providers in 2016 under the ESRD Prospective Payment System (PPS) for renal dialysis services. CMS estimates...more

President Signs Tax Bill with Medicare Provisions, Ebola Treatment/Vaccine Bill

In December 2014, President Obama signed into a law H.R. 5771, a tax extender bill that includes the “Achieving a Better Life Experience (ABLE) Act of 2014.” ...more

CMS Issues 2015 ESRD and DMEPOS Final Rule

On October 31, 2014, CMS issued a final CY 2015 End-Stage Renal Disease (ESRD) PPS and Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) final rule. CMS finalized its proposal to increase overall ESRD...more

CMS Releases CY 2015 ESRD PPS and DMEPOS Proposed Rule

On July 2, 2014, CMS released the CY 2015 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) Proposed Rule. ...more

CMS Issues Proposed Rule Updating ESRD PPS for CY 2014

CMS recently issued a proposed rule detailing updates and revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2014 and requirements for the ESRD quality incentive program...more

CMS Updates Manual to Reflect Ambulance Fee Schedule Reduction for Non-Emergency BLS Transports of Patients With ESRD

On May 10, 2013, CMS issued a transmittal clarifying the requirement in Section 637 of the American Taxpayer Relief Act of 2012 (ATRA) that ambulance payments for non-emergency basic life support (BLS) transports for end...more

Stark Exception For ESRD Not Recognized In Florida

On January 10, 2013, the U.S. Court of Appeals for the Eleventh Circuit ruled in Fresenius Medical Care Holdings, Inc. v. Tucker, that an arrangement can violate Section 456.053 of the Florida Statutes, also known as...more

CMS’s Innovation Center Announces New Initiative on Comprehensive ESRD Care

On February 4, 2013, CMS’s Innovation Center announced a new initiative to test a payment and service delivery model for beneficiaries with end-stage renal disease (ESRD). The initiative, named Comprehensive ESRD Care (CEC),...more

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