Centers for Medicare & Medicaid Services - Special Open Door Forum:
End Stage Renal Disease Prospective Payment System Proposed Rule Overview
Thursday October 15, 2009
3:30PM - 5:00PM EDT
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) proposed rule that went on display at the Federal Register on September 15, 2009. The primary audiences for this Special ODF are ESRD facilities and provider, supplier, laboratory and beneficiary groups.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) was enacted on July 15, 2008. Section 153(b) of MIPPA amended section 1881(b) of the Social Security Act to require the implementation of an end-stage renal disease (ESRD) bundled payment system effective January 1, 2011 (herein referred to as the "ESRD PPS").
In the September 29, 2009 Federal Register (74 FR 49922), we published a proposed rule outlining the proposed ESRD PPS. This ESRD PPS proposed rule would implement a case-mix adjusted bundled prospective payment system (PPS) for Medicare outpatient ESRD facilities beginning January 1, 2011, in compliance with section 153(b) of MIPPA. The proposed ESRD PPS would replace the current basic case-mix adjusted composite payment system and the methodologies for the reimbursement of separately billable outpatient ESRD services.
During this ODF, CMS staff will highlight the key features of the proposed ESRD PPS including the:
• composition of the bundle and basis for the proposed unit of payment;
• data sources used in developing the system;
• proposed patient-level and facility-level case mix adjusters;
• proposed outlier policy; and
• proposed market basket.
CMS will also discuss implementation issues associated with the proposed system, highlight key findings reflected in the impact analysis, provide a brief overview of the quality incentive program that CMS discusses as a conceptual model with the proposal of three quality measures for 2012, and summarize issues that have been identified for further analysis within the final rule.
Afterwards, there will be an opportunity for the public to ask questions.
Discussion materials for this Special ODF will be available to download at http://www.cms.hhs.gov/ESRDPayment/ by October 14, 2009.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935
Reference Conference ID#: 26811397
Note: TTY Communications Relay Services are available for the Hearing Impaired.
For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
An audio recording and transcript of this Special Open Door Forum will be posted to the Special Open Door Forum website: http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning October 25, 2009 and will be available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Thank you for your interest in CMS Open Door Forums.
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