A Centers for Medicare & Medicaid Services (CMS) proposal would cut providers' reimbursement for dialysis treatment by 9.4%, or approximately $1 billion, nationwide.
A Centers for Medicare & Medicaid Services (CMS) proposal would cut providers’ reimbursement for dialysis treatment by 9.4%, or approximately $1 billion, nationwide. Such changes alarm providers in the aftermath of other funding reductions that have affected Medicare, including the government sequestrian, and other mandates associated with health reform. The recommendations are part of adjustments to the end-stage renal disease (ESRD) program.
“This is a very dramatic cut," Robert Sepucha, Senior VP, Policy and Business Development at Fresenius Medical Care, said. “We’re concerned it would push dialysis clinics under the cost of care, which is not the right thing for Medicare to be doing.”
Recent estimates show that 85% of American dialysis patients rely on Medicare to receive kidney disease treatment. The CMS cuts would affect almost half a million Americans, threating the quality of care for some of the most sickly and vulnerable patients. An additional 20 million of those affected are at increased risk of ESRD due to health and genetic factors and may require dialysis in the future.
Heather Dauler, Director of Government Affairs at Satellite Healthcare, said communities rely on providers like the Satellite clinic to provide high quality care in an accessible way. “While we will continue to strive to meet these needs, the extent of the proposed cuts may compromise our ability to do so,” Ms Dauler commented.
Medicare had already faced difficulties in covering costs for many ESRD patients, even before the sequestrian effects.
"Dialysis providers are struggling to absorb and adjust to the other Medicare cuts made to the program in recent years," said Ron Kuerbitz, Chair of Kidney Care Partners. "The current proposal is untenable, and would dramatically underfund this crucial therapy for Medicare beneficiaries on dialysis. To protect the well-being of our patients, CMS must ensure that Medicare reimbursement is adequate to cover the cost of providing quality care.”
The CMS proposal remains open to public comment until August 30.
Around the Web
DaVita Among Dialysis Outlets Facing 9.4% Medicare Cut [Bloomberg]
Proposed Medicare Cuts Have Broad Implications For Dialysis Services Offerings [Herald Online]
Nation's Kidney Community Deeply Concerned Over Government's "Untenable" Proposed Cut to the Nation's Medicare's Dialysis Program
The Legal Architecture of Psychedelic Therapy: Risks, Responsibilities, and Reimbursement Realities
July 30th 2025Key legal, ethical, and compliance considerations for managed care professionals navigating the evolving landscape of psychedelic-assisted therapy include regulatory risks, data privacy challenges, reimbursement limitations, and the need for culturally informed care models.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Effects of Adjunctive Cariprazine Formulary Restrictions in Major Depressive Disorder
July 23rd 2025Patients who experienced a formulary-related rejection of cariprazine for adjunctive treatment of major depressive disorder had significantly higher hospitalization rates than those with approved claims.
Read More