9/10 CY2019 ESRD PPS Proposed Rule

CMS has released a proposed rule for the CY2019 ESRD PPS, titled Proposed Updates to Policies and Payment Rates for the ESRD PPS, … QIP; and Payment for Renal Dialysis Services Furnished to Individuals with AKI and a fact sheet summarizing it.  The ellipsis in the title refers to durable medical equipment changes included in the same proposed rule.  Find the fact sheet at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-11.html.

The fact sheet includes summaries of:

  • Removing the Healthcare Personnel Vaccination, Pain Assessment, Anemia Management, and Serum Phosphorus reporting measures from the PY2021 QIP.
  • Restructuring domains and weights in the PY2021 QIP.
  • Expanding NHSN validation in both PY2021 and PY2022.
  • Adding measures for Percentage of Patients Waitlisted and Medication Reconciliation to the PY2022 QIP.
  • Adding a measure on Standardized First Transplant Waitlist Ratio for Incident Patients to the PY2024 QIP.

The proposed rule can be found on the Federal Register at https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14986.pdf.  Comments must be received by September 10, 2018.

CDC HAN on Coagulopathy

CDC has published a Health Alert Network advisory on vitamin K-dependent antagonist coagulopathy caused by synthetic cannabinoids apparently contaminated with the rodenticide brodifacoum.  While CDC does not report any cases from the West Coast, they advise proceduralists who deal with blood, and others, to be aware of the possibility.  The HAN includes:

  • Recommendations for clinicians, including notifying health authorities, especially in cases where a synthetic cannabinoid user has recently donated blood
  • Recommendations for public health officials, including notifying CDC
  • Recommendations for the general public, including avoiding synthetic cannabinoids

For details see https://emergency.cdc.gov/han/han00410.asp.

There is no suggestion that natural, non-synthetic cannabinoids are similarly contaminated; these are regulated and legal by state law in all of Networks 16 and 18 except Idaho, and increasingly used for medical purposes.  There is also no suggestion that natural, non-synthetic, non-psychoactive CBD oil made from industrial hemp, which is available throughout the US, is similarly contaminated; however, outside of the regulated marketplace, industrial-hemp CBD oil is unregulated, so the potential for contamination of some kind is always present.

2/22 CDC Injection Safety Webinar

CDC will present a free February 22, 2018 webinar on Empowering Nurses to Protect Themselves and Their Patients: Exploring Best Practices in Injection Safety.  For details and registration, see https://cc.readytalk.com/registration/#/?meeting=g3qmrx0o1rdc&campaign=j5n63qeujgek.  For recordings of previous webinars, see https://www.cdc.gov/infectioncontrol/training/safe-healthcare-webinars.html.

2/15+ NWRD Conference Spokane

The payment deadline for discounted registration to the 2018 NWRD Annual Conference is February 15, 2018.  The Conference will be held March 8-9, 2018 in Spokane WA.  Register at http://www.nwrdonline.org/registration-2018.  Find the agenda, with includes Native American diets and disparities, disaster relief, vegetarian and vegan diets, transplant, diabetes, home hemo, new medications, EOL, and mentoring, at https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/NWRD/NWRD.0318.pdf.

2/15+ NWRD Conference Spokane

The 2018 NWRD Annual Conference will be held March 8-9, 2018 in Spokane WA.  Payment received by February 15, 2018 will be discounted $50.  Register at http://www.nwrdonline.org/registration-2018.  The agenda includes CKD, disparities, and diet among Native American patients, hurricane relief, vegetarian and vegan diets, transplantation, diabetes, home hemo, new medications, EOL, mentoring, and a “3K Walk and Talk” along the Spokane River featuring best practices to “Renew, Refocus, and Refresh.”  Fourteen CPEUs are available.  Find the agenda at https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/NWRD/NWRD.0318.pdf.

The Conference also includes an evening networking opportunity, cooking class, and renal diet workshop called Cultivate your CKD Culinary Skills led by NKF chef instructor Duane Sunwold of the Inland Northwest Culinary Academy.  Chef Sunwold, an experienced chef, culinary arts instructor, and former kidney patient, was able to put his kidney disease in remission, in part by changing his lifestyle and diet.  He will share professional techniques for teaching patients how to improve their diet.  Two additional CPEUs are offered for the evening.  Find more information at https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/NWRD/NWRD.0318.Networking.pdf.

There is also space available for a few more poster sessions on your special project, teaching method, idea, or research; find details at http://www.nwrdonline.org/registration-2018.

CDC HAN re Flu

CDC has issued a “HAN” Health Advisory on increased influenza A(H3N2) activity and its clinical implications.  The HAN also includes a summary of influenza antiviral drug treatment recommendations, an update about approved treatment drugs and current supply, and background information for patients about influenza treatment.  Find the HAN at https://emergency.cdc.gov/han/han00409.asp.

CMS has also recently published a list of flu vaccine resources, at https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2016-12-08-eNews.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending#_Toc468862699.