Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC H. Provisions Related to Payment for Renal Dialysis Services Furnished by End-Stage Renal Disease (ESRD) Facilities In the CY 2009 PFS proposed rule (73 FR 38527), we outlined for CY 2009 the proposed updates to the case-mix adjusted composite rate payment system established under section 1881(b)(12) of the Act, added by section 623 of the MMA. These included updates to the drug add-on component of the composite rate system, as well as the wage index values used to adjust the labor component of the composite rate. Specifically, we proposed the following provisions which are described in more detail below in this section: ● A zero growth update to the proposed 15.5 percent drug add-on adjustment to the composite rates for 2009 required by section 1881(b)(12)(F) of the Act (resulting in a $20.33 per treatment drug add-on amount). ● An update to the wage index adjustment to reflect the latest available wage data, including a revised BN adjustment factor of 1.056672; ● The completion of the 4-year transition from the previous wage-adjusted composite rates to the CBSA wage-adjusted rates, where payment will be based on 100 percent of the revised geographic adjustments; and 162
CMS-1403-FC 0.7000. ● A reduction of the wage index floor from 0.7500 to A total of 56 comments were submitted under the caption “ESRD PROVISIONS.” Eight of these comments pertained to the proposed changes to ESRD payment related provisions listed above. The remaining 48 comments responded to the solicitation for public comment pertaining to the application of preventable hospital-acquired condition (HAC) payment provisions for IPPS hospitals in settings other than IPPS hospitals, including ESRD facilities. Please refer to section II.H.6. of this final rule with comment period for a discussion of the applicability of the HAC payment provision for IPPS hospitals in settings other than IPPS hospitals. The ESRD payment related comments are discussed in detail below in this section. In addition, subsequent to the publication of the CY 2009 PFS proposed rule, section 153 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275), enacted on July 15, 2008, mandates changes in ESRD payment effective January 1, 2009. Section 153(a) of the MIPPA amends section 1881(b)(12)(G) of the Act to increase the composite rate component of the payment system and amends section 163
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<strong>CMS</strong>-1403-FC<br />
H. Provisions Related to Payment for Renal Dialysis<br />
Services Furnished by End-Stage Renal Disease (ESRD)<br />
Facilities<br />
In the CY 2009 PFS proposed rule (73 FR 38527), we<br />
outlined for CY 2009 the proposed updates to the case-mix<br />
adjusted composite rate payment system established under<br />
section 1881(b)(12) of the Act, added by section 623 of the<br />
MMA. These included updates to the drug add-on component<br />
of the composite rate system, as well as the wage index<br />
values used to adjust the labor component of the composite<br />
rate.<br />
Specifically, we proposed the following provisions<br />
which are described in more detail below in this section:<br />
● A zero growth update to the proposed 15.5 percent<br />
drug add-on adjustment to the composite rates for 2009<br />
required by section 1881(b)(12)(F) of the Act (resulting in<br />
a $20.33 per treatment drug add-on amount).<br />
● An update to the wage index adjustment to reflect<br />
the latest available wage data, including a revised BN<br />
adjustment factor of 1.056672;<br />
● The completion of the 4-year transition from the<br />
previous wage-adjusted composite rates to the CBSA<br />
wage-adjusted rates, where payment will be based on<br />
100 percent of the revised geographic adjustments; and<br />
162