CMS Delays Start of First Performance Year Period for Kidney Care Choices Model

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On March 5, 2020, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced that it is delaying the inception of the Kidney Care Choices (KCC) Model’s first performance year until Jan. 1, 2022.

The CMS’ KCC Model’s Kidney Care First (KCF) Option and the Comprehensive Kidney Care Contracting (CKCC) Option incentivize healthcare providers to manage the care of Medicare beneficiaries with chronic kidney disease stages 4 and 5 and end-stage renal disease. Unlike prior value-based kidney care models, the KCF and CKCC options are voluntary models that include both chronic kidney disease and end-stage renal disease beneficiaries, but align patients based on nephrology care, rather than based on dialysis treatments.

The KCC Model’s implementation period started Oct. 15, 2020, and was slated to end March 31, 2021, with the performance year period scheduled to start April 1, 2021. Due to the delayed start date of the performance year period, the implementation period will extend through the end of 2021 and will provide the model participants with additional data as they prepare to take on financial and population health accountability starting in January 2022.

As a result of the delay in the start of the first performance year, the “Notice of Waiver of Certain Fraud and Abuse Laws in Connection With the Comprehensive Kidney Care Contracting Options of the Kidney Care Choices Model,” issued by CMS on Sept. 9, 2020, will remain in effect for the duration of the implementation period, and is applicable to entities already selected to participate in the CKCC option of the KCC Model. CMS has not yet promulgated a similar waiver of the fraud and abuse laws related to the performance year period.

McGuireWoods will provide additional information as CMS adjusts the KCC Model and as information becomes available.

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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