CMS finalizes dialysis rule

Nov. 4, 2020

The Centers for Medicare & Medicaid Services (CMS) finalized policies that provide financial incentives for in-home dialysis of patients with end stage renal disease (ESRD), according to a press release from the agency.

The rule, which goes into effect in January 2021, allows “certain new and innovative equipment and supplies used for dialysis treatment of patients with End-Stage Renal Disease (ESRD) in the home to qualify for an additional Medicare payment. The final rule encourages the development of new and innovative home dialysis machines that give Medicare beneficiaries with ESRD more dialysis treatment options in the home that can improve their quality of life,” CMS said.

CMS is expanding eligibility for a transitional add-on payment adjustment for new and innovative equipment and supplies (TPNIES) that was introduced last year to now cover qualifying new dialysis machines when used in the home. 

Currently, more than 85 percent of Medicare fee-for-service beneficiaries with ESRD travel to a facility to receive their dialysis at least three times per week, spending, on average, 12 hours each week attached to a dialysis machine. Additionally, as ESRD patients are among the most vulnerable population covered by Medicare, due to multiple chronic conditions and comorbidities, they have had the highest hospitalization rates due to COVID-19 among Medicare beneficiaries. 

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