More December+ Events

December 6, 2023: Medicaid/CHIPS Renewal Webinar, What to Know and How to Prepare: A Partner Education Monthly Series, online, find more information and registration at https://cms.zoomgov.com/webinar/register/WN_qma5AvyBQWCTB0vbNF3lTA#/registration.

December 14, 2023: EQRS Town Hall re ESRD Reporting Deadlines, EQRS Updates including Dashboard Reports, CY2024 ESRD Final Rule, New Facility Commitment to Health Equity Measure, PY2024 QIP Final PSRs/PSCs, online, more information and registration at https://mycrownweb.org/pcw_community_events/december-2023-town-hall/.

January 2, 2024: CY2024 ESRD/AKI Updates Effective, summarized at https://www.cms.gov/files/document/mm13445-esrd-acute-kidney-injury-dialysis-cy-2024-updates.pdf.

January 2-March 29, 2024: Longer CCSQ Hold Times Expected for EQRS questions; for more information, see the 2-page attachment below. The embedded links don’t work, but they are:

• CCSQ Support Central – https://cmsqualitysupport.servicenowservices.com/ccsq_support_central.
• CrownWeb: https://mycrownweb.org/.
• QualityNet Q&A Tool – https://cmsqualitysupport.servicenowservices.com/qnet_qa?id=ask_a_question.
• Support email address: qnestsupport-esrd@cms.hhs.gov.

January 24, 2024: Medicaid/CHIPS Renewal Webinar, What to Know and How to Prepare: A Partner Education Monthly Series, online, find more information and registration at https://cms.zoomgov.com/webinar/register/WN_qma5AvyBQWCTB0vbNF3lTA#/registration.

Longer CCSQ Hold Times Expected bulletin:

CMS News: ESRD/AKI Billing, Cognitive Assessment, Drug Prices

Todays MLN Matters bulletin from CMS includes articles on:

• CY 2023 Updates: ESRD & AKI Dialysis on changes to policies and rates (see https://www.cms.gov/files/document/mm12978-esrd-acute-kidney-injury-dialysis-cy-2023-updates.pdf).
• Billing for separate treatments for Cognitive Assessment & Care Plan Services (see https://www.cms.gov/cognitive).
• Key Dates for the First Year of the Inflation Reduction Act’s Medicare Drug Price Negotiation Program (see https://www.cms.gov/newsroom/press-releases/hhs-announces-key-dates-first-year-inflation-reduction-acts-medicare-drug-price-negotiation-program). Negotiations begin in 2023, and negotiated prices take effect in 2026. This document notes that the IRA has already made vaccines free, capped insulin prices, changed pricing for biosimilars, required rebates on some drug price increases, and expanded eligibility for health insurance subsidies. It also mentions Part B (Medicare coverage of immunosuppresive drugs for transplant recipients), but Part B is detailed elsewhere (see https://nwrnbulletins.wordpress.com/2022/12/22/mln-mattrs-medicare-part-b-id-transplant-drugs/).

Find the full bulletin at https://www.cms.gov/outreach-and-education/outreach/ffsprovpartprog/provider-partnership-email-archive/2023-01-12-mlnc#_Toc124335724.

Final Rule QIP PY2023-26

CMS has published a Fact Sheet on the CY2023 ESRD PPS Final Rule, at https://www.cms.gov/newsroom/fact-sheets/calendar-year-2023-end-stage-renal-disease-esrd-prospective-payment-system-pps-final-rule-cms-1768-f. The Final Rule includes updates to the QIP, AKI, ETC, and other PPS policy and payment schedules, and COVID-19 adjustments. It also describes finalized changes to the QIP for PY2024, 2025, and 2026, and summarizes comments received in response to RFIs on Home Dialysis, Healthcare Quality Disparities, and Screenings for Social Drivers of Health. The full Final Rule is published in the Federal Register at https://www.federalregister.gov/public-inspection/2022-23778/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis.

8/22 Comments Due on CY2023 and PY2024-26 QIP

CMS has published a Proposed Rule with changes to the CY2023 ESRD QIP. Your comments are due by August 22, 2022. The Proposed Rule includes:

• Updated payment rates and policies for CY2023 including the outlier threshold, the Bundled market basket, labor-related share, wage index, and facility-level adjustments.
• Updated AKI payment rates for CY2023.
• Updated QIP Requirements, Measures, and Baseline for CY2023 including COVID-related adjustments.
• Requests for Information on QIP Measures including new and oral drugs, health equity, pediatric payment rates, home dialysis, Disparities, Social Drivers of Health.
• Adjustments to PY2024 Measures.
• Adjustments to PY2025-26 Measures.
• Refinements to the ESRD Treatment Choices Model.

Find:

• A Summary of the changes at https://www.cms.gov/newsroom/fact-sheets/calendar-year-2023-end-stage-renal-disease-esrd-prospective-payment-system-pps-proposed-rule-cms,
• The Federal Reserve Notice of the Proposed Rule at https://www.federalregister.gov/public-inspection/2022-13449/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis, and
• Instructions for commenting, before August 22, 2022, are included in the Federal Reserve Notice.

New CMS Rule for CY2022

CMS has published an update for CY2022 to the QIP, ETC Model, and PPS AKI payments. Among other issues, the update emphasizes Healthcare Equity and the lingering impact of COVID-19. Find a summary Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/cy-2022-end-stage-renal-disease-prospective-payment-system-final-rule-cms-1749-f, and the Final Rule at https://public-inspection.federalregister.gov/2021-23907.pdf.

10/15+ EQRS Training, Town Hall, Help Line, News, 2728

💥 An online EQRS New User Training course will be held on October 19, 2021. Find more information and register at https://mycrownweb.org/pcw_lems/october-2021-new-user-training/.

💥 The CMS ESRD Town Hall on November 18, 2021 will cover the PY2022 QIP Preview Period, EQRS CY2021 reporting requirements, new EQRS features, Telehealth Usage, and other EQRS announcements and updates. Find more information and register at https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1498979&tp_key=00b2612361.

💥 CRAFT Mailbox Transition to QualityNet Q&A Tool: EQRS Technical Assistance questions should now be submitted to the QualityNet Q&A Tool at https://cmsqualitysupport.servicenowservices.com/qnet_qa?id=ask_a_question. The CRAFT mailbox will no longer be monitored after October 29, 2021, and emails will not be answered. To submit a question through the Q&A Tool, select “ESRD QIP” from the Program drop-down list under Topic, and then select “EQRS Technical Assistance” from the General ESRD QIP sub-menu to submit your question. Be as detailed as possible to ensure that your question and/or issue is effectively answered.

💥 Find the October EQRS Newsletter, now published quarterly, at https://mycrownweb.org/2021/09/october-2021-newsletter/. The issue includes articles on:

• 2020-21 data submission deadlines (two articles),
• The PY2022 QIP Preview Period, which will span 30 days beginning in early November,
• Navigating the QIP User Interface in EQRS,
• A new EQRS feature on Kt/V,
• A “Chat” on AKI,
• The QualityNet Q&A Tool summarized above, and
• The new EQRS Security Measure outlined in the previous post of this blog.

💥 CMS 2728 Form Completion Process: CMS also wishes to remind facilities that it is important to complete the correct steps when processing the CMS 2728 ESRD Medical Evidence Report: Medicare Entitlement and/or Patient Registration form. Doing so ensures that patients’ Medicare benefits are activated and that the dialysis facility is reimbursed for services rendered to the patient. Follow the steps below to correctly complete and process the CMS 2728 form:

• Step 1: Enter and save all confirmed patient information into the CMS-2728 form in EQRS.
• Step 2: Print the CMS-2728 form and have the nephrologist and patient sign the printed copy.
• Step 3: Enter in EQRS the dates that the nephrologist and the patient signed the CMS-2728 form.
• Step 4: Click Submit to electronically upload the completed form in EQRS.
• Step 5: Mail the completed and signed CMS-2728 form to the local Social Security Administration office.

Step 5 ensures that Medicare benefits and facility reimbursements are quickly processed. Failure to do so may prevent and/or delay these important items. For detailed instructions, refer to the 2728 form at https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS2728.pdf. Submit any questions to the QualityNet Q&A Tool, summarized above, at https://cmsqualitysupport.servicenowservices.com/qnet_qa?id=ask_a_question.

7/12+ QIP Updates; Resume EQRS Clinical Data Entry

We haven’t found notice on their website yet, but in an email after COB on July 2, 2021, CMS/EQRS announced that facilities and providers can begin on July 12, 2021 entering into EQRS Clinical Data, ICH CAHPS Attestation, and Clinical Depression Screening and Follow-Up Plan data, for September through December 2020 only. This data must be entered by September 1, 2021 at 11:59 pm PT. This applies to both HD and PD, and all submission methods. Providers and facilities are urged to avoid bunching this data entry in late August, because corrections cannot be made after September 1, and the data will be used for their PY2022 QIP. That gives providers about four weeks to enter four months worth of Clinical and other QIP data. Entry of this data was suspended at the end of January 2021. We expect to find this information published soon at https://mycrownweb.org/#cmstag. See also the next post.

CMS/EQRS will announce separately when 2021 data can be entered into EQRS for the PY2023 QIP.

Separately, CMS has announced in a Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/end-stage-renal-disease-esrd-prospective-payment-system-pps-calendar-year-cy-2022-proposed-rule-cms that a Proposed Rule for the CY2022 QIP has been posted to the Federal Register. This Fact Sheet and the Proposed Rule include:

• Payment rate updates, including for AKI;
• Changes to, and requests for comments on, the ETC Model;
• Formalization of the delays detailed above;
• Advice that no facility would receive a payment reduction for PY2022;
• COVID- and EQRS-related adjustments to some PY2022 QIP measures;
• Proposal to base PY2024 performance standards on CY2019;
• Request for information on COVID-19 vaccinations;
• Request for information on health disparities;
• Request for comments on certain demographic and electronic data plans;
• Request for comments on future QIP measurement and data collection plans.

Find the Federal Register notice itself at https://www.federalregister.gov/public-inspection/2021-14250/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis.

EQRS has also announced:

• An EQRS Town Hall on July 8, 2021; see https://mycrownweb.org/pcw_community_events/july-2021-town-hall/.
• EQRS New User Training on July 20, 2021; see https://mycrownweb.org/2021/06/nut-july-2021-announce/.

11/17 CY2021 QIP Final Rule

CMS will publish the Final Rule for the CY2021 ESRD PPS, Payment for … AKI, and ESRD QIP in the Federal Register on November 9, 2020. A pre-publication copy can be found at https://www.federalregister.gov/public-inspection/2020-24485/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis.

On November 17, 2020 at 11am PST, CMS will hold a Stakeholder Call to discuss the QIP. Call details will be announced next week.

9/24 KDIGO Webinar on AKI & COVID-19

KDIGO will present a 6 am PDT September 24, 2020 webinar on AKI & COVID-19 (mid-afternoon in central Europe).  Find details below and register at https://us02web.zoom.us/webinar/register/WN_pSG3rzf5S2m9ArdKVgM0zA.

7/16+ AAKP/GWU Virtual Summit on Innovation

AAKP and George Washington University will present their Second Annual Global Summit: Global Kidney Innovations – Expanding Patient Choices & Outcomes, online, on July 16-17, 2020.  The full schedule (8-12 sessions per day plus evening webinars) will emphasize COVID-19 and Innovation, but many other topics as well.  Find more information, including the detailed agenda, and register at https://aakp.org/programs-and-events/2nd-annual-global-summit-global-kidney-innovations-expanding-patient-choices-outcomes/.