Medicare program; End-Stage Renal Disease prospective payment system, quality incentive program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Final rule.
This final rule will update and make revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2015. This rule also finalizes requirements for the ESRD quality incentive program (QIP), including for payment years (PYs) 2017 and 2018. This rule will also make a technical correction to remove outdated terms and definitions. In addition, this final rule sets forth the methodology for adjusting Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment amounts using information from the Medicare DMEPOS Competitive Bidding Program (CBP); makes alternative payment rules for certain DME under the Medicare DMEPOS CBP; clarifies the statutory Medicare hearing aid coverage exclusion and specifies devices not subject to the hearing aid exclusion; will not update the definition of minimal self-adjustment; clarifies the Change of Ownership (CHOW) and provides for an exception to the current requirements; revises the appeal provisions for termination of a CBP contract, including the beneficiary notification requirement under the Medicare DMEPOS CBP, and makes a technical change to the regulation related to the conditions for awarding contracts for furnishing infusion drugs under the Medicare DMEPOS CBP.
D003164:Competitive Bidding / Q000191:economics / Q000331:legislation & jurisprudence; D004389:Durable Medical Equipment / Q000191:economics*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000331:legislation & jurisprudence*; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000191:economics*; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence*; D009989:Orthotic Devices / Q000191:economics; D011445:Prospective Payment System / Q000191:economics* / Q000331:legislation & jurisprudence*; D019736:Prostheses and Implants / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics* / Q000331:legislation & jurisprudence*; D014481:United States