A major Medicare bill, which stalled in the Senate over partisan bickering late last month, includes some of the most sweeping changes to how the federal government pays providers of kidney-care services, and could be voted on as soon as this week.
Separately, in its proposed physician payment schedule released in recent weeks, the CMS also made some expected payment adjustments to its kidney-treatment program, boosting pay levels for certain drugs while clarifying quality reporting measures. Under the proposal, the CMS would freeze its dialysis drug add-on amount at $20.33 for 2009, which is this years rate. The proposed rule also reflects the final year of a four-year phase-in of lowered wage-index payments.
The Medicare bill contains provisions long sought by the tightknit community of doctors and providers who treat kidney disease. The bulk of the bill is geared toward reversing a steep Medicare pay cut to doctors, but a number of provisions are aimed at kidney specialists and represent a move away from the current system of reimbursement to an all-inclusive one.
Under the measure, proponents of the legislation said that it will not only save Medicare money, but also give dialysis and other kidney-care specialists a level of predictability and transparency in their paymentssomething they say has been missing since Medicare moved to a composite rate of payment in the early 1980s.
This would be the largest change the dialysis community has seen really since the introduction of the program, said Kathy Lester, a partner at the Washington law firm of Patton Boggs and a consultant for Kidney Care Partners, a coalition of dialysis providers, manufacturers and patient advocates.