CMS Releases 2017 Final Rule For ESRD Prospective Payment System – On October 28, 2016, CMS released the final rule for the End-Stage Renal Disease (ERSD) Prospective Payment System (PPS) that updates and makes revisions to the ERSD PPS and finalizes policies for coverage and payment for renal dialysis services furnished by an ERSD facility to beneficiaries on or after January 1, 2017.  The rule also sets forth requirements for the ERSD Quality Incentive Program (QIP), including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP.  The rule is scheduled to be published in the Federal Register on November 4, 2016.  A copy of the unpublished PDF version is available here.

Average Benchmark Premiums Under the ACA Expected to Increase 25 Percent in 2017 – On October 24, 2016, the HHS Office of the Assistant Secretary for Planning and Evaluation issued a research brief confirming the widely-reported sharp increases in premiums expected for 2017.  The research brief shows that across the 39 states using the HealthCare.gov platform, the average increase in the second-lowest-cost silver plan (the benchmark for premium tax credits) is 25 percent.  The average increases in 2015 and 2016 were only two percent and seven percent, respectively.  The research brief contends that “notwithstanding higher benchmark premium increases than in previous years, the majority of consumers will continue to have access to affordable coverage because they are protected by the combination of financial assistance and the ability to shop.”  The HHS research brief is available here.