RPA Perspective: 2025 Medicare Fee Schedule and ESRD PPS Final Rules—Highlights for Nephrology - The final rule for the 2025 Medicare Physician Fee Schedule was released on November 1, and the highlights from the rule...more
NY Governor vetoes noncompete ban bill after opposition from health, business groups - Kathy Hochul vetoed a bill passed by both houses of the NY legislature in June that would’ve imposed bans of non-compete clauses in...more
Fresenius hiring Ascension Capital exec to head care delivery - The appointment of Craig Cordola as CEO of the dialysis company’s care delivery segment takes effect Jan. 1. He was at Ascension Capital for the past six...more
On Oct. 27, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will increase payments to end-stage renal disease (ESRD) facilities in calendar year (CY) 2024. The ESRD prospective payment system...more
NY non-compete ban still receiving pushback as Governor waits to sign off - While NY Governor Kathy Hochul waits to sign off on one of the country’s toughest bans on non-compete agreements, many lobby groups from the...more
Benesch: MN ban on non-compete agreements includes carveout for business sale, dissolution - Benesch Law notes the bill only awaits the signature of MN’s Governor and could become law as early as July 1. It would prevent...more
On March 22, 2023, the Centers for Medicare and Medicaid Services (“CMS”) issued revised Guidance and Survey Process for Reviewing Home Dialysis Services in a Nursing Home (Rev QSO-18-24-ESRD) to State Survey Agency...more
ME trial reminiscent of DaVita anti-poaching case that also ended in acquittal; DOJ strategy questioned - In Apr. 2022, juries in TX and CO acquitted healthcare companies charged by the DOJ’s Antitrust Division. In the CO...more
Correction to our January 31, 2023 newsletter article, “Dialysis Provider Satellite Healthcare Reports Data Breach Affecting Nearly 100k Patients”: Media Statement, Satellite Healthcare - In January 2023, Satellite...more
Federal omnibus spending bill rolls back some Medicare payment cuts scheduled for 2023, 2024 - Buried within the $1.7-trillion spending package signed by the President on Dec. 29 was partial relief for a planned 4.5% cut...more
Rule Addresses Rate Increases, Outlier, Add-On and ETC Model Payments, Oral-Only Drugs and QIP Reporting - On Oct. 31, 2022, the Centers for Medicare & Medicaid Services issued a final rule implementing an increase in...more
SCOTUS sides with OH-based medical plan in dispute with DaVita over dialysis reimbursements - In a 7-2 vote, the Supreme Court ruled in favor of the Marietta Memorial Hospital Employee Benefit Plan in a case that hinged...more
On June 21, 2022, the Supreme Court concluded, in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, 2022 WL 2203328 (U.S. June 21, 2022), that the terms of a benefit plan limiting...more
SCOTUS to consider case alleging private plan’s ESRD coverage violates MSPA - The Supreme Court agreed to hear the case of Marietta Memorial Hospital Employee Health Benefits Plan v. DaVita, which alleges a private...more
Industry players agree on need for quality assurance but believe CMS’ QIP program for ESRD care delivery flawed - The ESRD Quality Incentive Program (QIP) implemented by CMS provides a payment penalty of up to 2% for...more
The Calendar Year (CY) 2021 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule, CMS-1732-F (Final Rule) was published in the Federal Register on November 9, 2020. The Final Rule includes payment...more
Last week, CMS announced the finalized End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model), which will test whether incentivizing home dialysis and kidney transplantation will reduce Medicare expenditures while...more
Telehealth continues to be a frontrunner on one strategy to achieve the triple aim, an effort to improve patient experience, population health and reduce per capita cost. To date, government reimbursement for telehealth...more
On June 26, 2015, CMS released a Proposed Rule to increase payments by 0.3% for end-stage renal disease (ESRD) care providers in 2016 under the ESRD Prospective Payment System (PPS) for renal dialysis services. CMS estimates...more