Kidney dialysis providers would get a 2.2% Medicare reimbursement hike next year under a proposed rule the Centers for Medicare and Medicaid Services issued Thursday.
The agency also intends to go forward with a payment bundling plan including oral-only drugs for kidney disease patients with high phosphorus levels. Dialysis providers have said making them responsible for supplying medicines patients can get at retail pharmacies is infeasible.
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CMS originally floated adding oral-only phosphate binder drugs to the end-stage renal disease payment bundling program in 2011. After Congress delayed the policy three times, the agency now intends to implement it in 2025. Two House committees have approved legislation this year that would postpone it again, this time until 2027.
The proposed rule specifies what drugs would be included in the bundle. CMS asserts the policy will improve access to these medications.
Kidney Care Partners, a trade group representing dialysis providers, argues the bundling proposal would strain the workforce and threaten access to care.
"KCP is deeply concerned about the sustainability of the program given that the market basket fails to reflect the actual increase in costs incurred by facilities. Moreover, we are disappointed that CMS did not heed the kidney care community’s call for reforms to address the barriers the current payment policies have created in terms of patients being able to access innovative treatment options," the association said in a statement.
Denver-based DaVita and Waltham, Massachusetts-based Fresenius Medical Care did not respond to requests for comment.
The draft regulation also would alter the wage index for ESRD providers by basing it on freestanding dialysis center costs and Labor Department wage data instead of on hospital data.
