News & Analysis as of

Medicare Dialysis

Benesch

Dialysis & Nephrology Digest - January 2024

Benesch on

NY Governor vetoes noncompete ban bill after opposition from health, business groups - Kathy Hochul vetoed a bill passed by both houses of the NY legislature in June that would’ve imposed bans of non-compete clauses in...more

Benesch

Dialysis & Nephrology Digest - November 2023

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Fresenius hiring Ascension Capital exec to head care delivery - The appointment of Craig Cordola as CEO of the dialysis company’s care delivery segment takes effect Jan. 1. He was at Ascension Capital for the past six...more

McGuireWoods LLP

CMS Issues End-Stage Renal Disease Prospective Payment System Final Rule for 2024

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On Oct. 27, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will increase payments to end-stage renal disease (ESRD) facilities in calendar year (CY) 2024. The ESRD prospective payment system...more

Benesch

Dialysis & Nephrology Digest - September 2023

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FTC, DoJ propose changes to HSR Act for more effective, efficient merger reviews - The FTC, along with the Assistant Attorney General of the Antitrust Division, proposed changes to the premerger notification form and...more

Benesch

Dialysis & Nephrology Digest - August 2023

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NY non-compete ban still receiving pushback as Governor waits to sign off - While NY Governor Kathy Hochul waits to sign off on one of the country’s toughest bans on non-compete agreements, many lobby groups from the...more

Benesch

Dialysis & Nephrology Digest - July 2023

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Benesch: NLRB decision overturns use of ‘entrepreneurial opportunity’ super factor for classifying employees - Benesch explains the labor board’s decision retains the 10-point test to determine who can be considered an...more

Benesch

Dialysis & Nephrology Digest - June 2023

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Benesch: MN ban on non-compete agreements includes carveout for business sale, dissolution - Benesch Law notes the bill only awaits the signature of MN’s Governor and could become law as early as July 1. It would prevent...more

Benesch

Dialysis & Nephrology Digest - April 2023

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ME trial reminiscent of DaVita anti-poaching case that also ended in acquittal; DOJ strategy questioned - In Apr. 2022, juries in TX and CO acquitted healthcare companies charged by the DOJ’s Antitrust Division. In the CO...more

Benesch

Dialysis & Nephrology Digest - March 2023

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Correction to our January 31, 2023 newsletter article, “Dialysis Provider Satellite Healthcare Reports Data Breach Affecting Nearly 100k Patients”: Media Statement, Satellite Healthcare - In January 2023, Satellite...more

Benesch

Dialysis & Nephrology Digest - January 2023

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Federal omnibus spending bill rolls back some Medicare payment cuts scheduled for 2023, 2024 - Buried within the $1.7-trillion spending package signed by the President on Dec. 29 was partial relief for a planned 4.5% cut...more

McGuireWoods LLP

CMS Issues ESRD Prospective Payment System Final Rule for 2023

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Rule Addresses Rate Increases, Outlier, Add-On and ETC Model Payments, Oral-Only Drugs and QIP Reporting - On Oct. 31, 2022, the Centers for Medicare & Medicaid Services issued a final rule implementing an increase in...more

Benesch

Dialysis & Nephrology Digest - October 2022

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Benesch outlines five states with data protection laws coming into effect in 2023 - Next year, statutes for data security and data privacy will go into effect in CA and VA on Jan. 1, while laws in CO and CT will be...more

Benesch

Dialysis & Nephrology Digest - September 2022

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Fresenius CEO resigning; to be replaced by head of company’s pharmaceutical business - Michael Sen, President and CEO of Fresenius Kabi, will replace Stephan Sturm as CEO of Fresenius SE on Oct. 1. Shares in the company...more

Benesch

Dialysis & Nephrology Digest - July 2022

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SCOTUS sides with OH-based medical plan in dispute with DaVita over dialysis reimbursements - In a 7-2 vote, the Supreme Court ruled in favor of the Marietta Memorial Hospital Employee Benefit Plan in a case that hinged...more

ArentFox Schiff

Supreme Court Holds Benefit Plan Limiting Dialysis Reimbursement Does Not Run Afoul of Medicare Secondary Payer Act

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On June 21, 2022, the Supreme Court concluded, in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, 2022 WL 2203328 (U.S. June 21, 2022), that the terms of a benefit plan limiting...more

Benesch

Dialysis & Nephrology Digest - April 2022

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SCOTUS questions appear to support DaVita’s position in dialysis care discrimination case - Private plans are supposed to provide coverage for dialysis for the first 30 months before the patients can transition to...more

Benesch

Dialysis & Nephrology Digest - March 2022

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CMS calls for applications for second cohort of KCC Model; deadline set for Mar. 25 - The Center for Medicare and Medicaid Innovation says performance period participation agreements for the CMS Kidney Care First Option...more

Benesch

Dialysis & Nephrology Digest - December 2021

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SCOTUS to consider case alleging private plan’s ESRD coverage violates MSPA - The Supreme Court agreed to hear the case of Marietta Memorial Hospital Employee Health Benefits Plan v. DaVita, which alleges a private...more

Benesch

Dialysis & Nephrology Digest - September 2021

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Industry players agree on need for quality assurance but believe CMS’ QIP program for ESRD care delivery flawed - The ESRD Quality Incentive Program (QIP) implemented by CMS provides a payment penalty of up to 2% for...more

Benesch

CMS Proposes Steep Cuts to Office-Based Dialysis Vascular Access Reimbursement...Again!

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On July 13, 2021 the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) proposed rule for calendar year (CY) 2022 that could result in potentially significant reductions to...more

Benesch

Dialysis & Nephrology Digest - March 2021 #2

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AMA report suggests Medicare spending fell 19% YoY during first half of 2020; reduction in nephrology much smaller The report from the American Medical Association (AMA) found Medicare payments to physicians the first six...more

Baker Donelson

CY 2021 ESRD PPS Final Rule Includes Policy Changes to Promote In-Home Dialysis

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The Calendar Year (CY) 2021 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule, CMS-1732-F (Final Rule) was published in the Federal Register on November 9, 2020. The Final Rule includes payment...more

ArentFox Schiff

The Medicare Secondary Payer Act Prohibits Disparate Impact Discrimination, the Sixth Circuit Rules

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The Sixth Circuit has issued an important decision that condemns plan provisions that provide different benefits based on a patient’s need for continued dialysis, even if the provision applies to all dialysis patients and not...more

Mintz - Health Care Viewpoints

CMS Announces Final Rule on ESRD Treatment Choices Model

Last week, CMS announced the finalized End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model), which will test whether incentivizing home dialysis and kidney transplantation will reduce Medicare expenditures while...more

Benesch

Dialysis & Nephrology Digest - September 2020

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DaVita commences $1B share buyback plan - Through what is called a modified Dutch auction, DaVita plans to purchase stock at between $77 and $88 per share. Shareholders whose shares are purchased will be paid the...more

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