Published August 5, 2020
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The Centers for Medicare and Medicaid Services (CMS) has proposed changes to Medicare coverage of in-home dialysis services for beneficiaries with kidney failure, or End-Stage Renal Disease (ESRD).
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The proposed changes would increase Medicare payments for new and innovative equipment and supplies used for dialysis treatment, in hopes of encouraging the further development of home dialysis machines.
According to a press release from the CMS announcing the proposal, more than 85% of Original Medicare beneficiaries with ESRD travel to a dialysis facility at least three times a week for treatment, spending at least 12 hours per week at the facility.
The proposal seeks to add home dialysis machines to the list of items that can qualify for TPNIES – or the transitional add-on payment adjustment for new and innovative equipment and supplies – that was introduced last year.
Data shows that among Medicare beneficiaries, people with ESRD have the highest rate of hospitalization from COVID-19. This is largely a result of these beneficiaries having compromised immune systems and having to regularly leave home to visit a medical facility for dialysis.
The new CMS proposal intends to help ESRD patients receive dialysis treatment from the safety of their own home.
“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. In the midst of a deadly pandemic President Trump’s call for increased access to home dialysis has never been more urgent.” - Seema Verma, CMS Administrator
The proposal adds to previous actions taken by the CMS to boost care for beneficiaries with ESRD and kidney failure:
Learn more about how Medicare is helping beneficiaries during the coronavirus pandemic.
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
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