The Centers for Medicare & Medicaid Services says that a new final rule will improve the determination process for an add-on payment adjustment to incentivize innovative dialysis equipment while supporting home dialysis for patients with end-stage renal disease.
The rule expands eligibility for the transitional add-on payment adjustment for new and innovative equipment and supplies introduced last year. Now, qualifying new dialysis machines are covered when used in the home. This change provides an additional Medicare payment when qualifying innovative equipment and supplies are used to expand access to new home dialysis machines and facilitate quicker availability to Medicare beneficiaries.
Currently, more than 85% of Medicare fee-for-service beneficiaries with ESRD travel to a facility to receive their dialysis at least three times per week, spending an average 12 hours per week attached to a machine away from home, according to CMS.
“Medicare beneficiaries with ESRD have long been ill-served by a system that too often fails to incentivize the types of care that yield the best health outcomes for their quality of life,” CMS Administrator Seema Verma said.