The Centers for Medicare & Medicaid Services (CMS) has issued its final rule updating the end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2022.
In addition to ESRD PPS payment rates updates, the rule includes changes to the ESRD Quality Incentive Program (QIP) and to the ESRD Treatment Choices Model to address health equity. The rule is effective Jan. 1, 2022.
CMS finalizes an ESRD PPS base rate of $257.90 for CY 2022 — an increase of $4.77 to the current base rate of $253.13. CMS also finalizes the proposal to expand the transitional add-on payment adjustment for new and innovative equipment and supplies to include a home dialysis machine.
In response to the COVID-19 public health emergency (PHE), CMS finalizes its proposal to suppress certain ESRD QIP measures, and to include two COVID-19 vaccine measures in the ESRD QIP measure set for the next rulemaking cycle. CMS also finalizes the proposal to adopt special scoring and payment policies for payment year (PY) 2022 to address technical issues with the ESRD Quality Reporting System and the impact of the COVID-19 PHE on some of the PY 2022 ESRD QIP measures. Under these finalized policies, no facility will receive a payment reduction for PY 2022.
Comments CMS received regarding feedback on ways to improve health equity and the agency’s future plans to define digital quality measures for the ESRD QIP will be taken into consideration as the agency works to develop policies to improve health equity.
A CMS fact sheet provides additional information.