CMS Issues 2024 ESRD Proposed Payment Rule – Dialysis Providers Would Receive Less Than a 2% Bump

On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would make changes to the end-stage renal disease (ESRD) Prospective Payment System (PPS) for dialysis services. The rule includes a slight pay increase for dialysis providers and increases payments for some dialysis drugs and biologics.

CMS is offering a base payment rate of $269.99 for 2024, which is an increase of $4.42 or 1.7%. The 2024 acute kidney injury dialysis payment rate for ESRD facilities will also be raised to the same amount. Modern Healthcare reports that the proposal includes an increase in provider reporting, such as patient time spent in-facilities and the amount of drug and biologic products discarded from single-use packaging.

Some drugs will be given a payment adjustment that will increase after the Transitional Drug Add-on Payment Adjustment (TDAPA) period ends. The Renal Healthcare Association, which has scheduled a webinar on the proposed rule on July 19, explains:

This proposed increase would help ensure payment is not a barrier to accessing innovative treatments for Medicare ESRD beneficiaries.

Oral-only prescription drugs are notably left out of the 2024 ESRD PPS. Inside Health Policy notes that the dialysis lobby fought to have them included ahead of 2025 as scheduled.  CMS indicated that it still intends to incorporate them into bundled payments.

The 2024 ESRD PPS proposed rule fact sheet can be found at CMS.