CMS proposes Medicare payment updates to increase use of home dialysis

The Trump administration has proposed an enhanced Medicare add-on payment to encourage greater use of home dialysis for beneficiaries with end-stage renal disease (ESRD).

The Centers for Medicare & Medicaid Services (CMS) issued an add-on payment last year to offer higher reimbursement for eligible home dialysis machines. In a rule proposed Monday, the agency said it would enhance that payment further, allowing for coverage for additional new and innovative home dialysis machines.

CMS has put a focus on kidney care of late, with the goal of increasing the uptake of home care options and increasing access to transplants. That work has included a slate of five new payment models.

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CMS Administrator Seema Verma said in a statement that the COVID-19 pandemic has highlighted further the need to increase access to home health options for Medicare beneficiaries.

“In the midst of a deadly pandemic that poses a particular threat to those with serious underlying conditions, President Trump’s call for increased access to home dialysis has never been more urgent. Unfortunately, government rules too often stand in the way," Verma said. "Today’s action represents a sorely needed course direction, making it easier for ESRD facilities to make new and innovative home dialysis machines available to patients who need them.”

CMS said in the announcement that, at present, about 85% of patients with ESRD undergo facility dialysis three or more times per week.