On June 29, 2015, President Obama signed into law the Trade Preferences
Extension Act of 2015, which provides for Medicare reimbursement for renal
dialysis services furnished to individuals with acute kidney injury. This
measure, which takes effect on January 1, 2017, has been long awaited by
dialysis providers. Frustration surrounding Medicare reimbursement for acute
dialysis services furnished in an outpatient dialysis facility dates back to a
statement issued by the Centers for Medicare and Medicaid Services (CMS) on July
18, 2012. CMS took the position that hospital outpatients may receive acute
dialysis only in a hospital or in locations that qualify as provider-based
departments of the hospital if they want those services reimbursed by Medicare.
The July 2012 statement presented considerable confusion in the dialysis
community regarding whether CMS was also stating that Medicare-certified
facilities could provide acute dialysis services. The recent legislation now
ensures that dialysis facilities will be reimbursed for acute dialysis
treatments rendered to Medicare beneficiaries as of January 1, 2017.
Specifically, Section 808 of the law amends the Medicare statutes to provide
coverage for “renal dialysis services furnished … by a renal dialysis facility
or provider … to an individual with acute kidney injury.” See H.B. 1295, 114th
Cong. (2015). Further, payment for furnishing acute dialysis services “shall be
the base rate for renal dialysis services determined for such year … as adjusted
by any applicable geographic adjustment factor” or otherwise adjusted by CMS.
For further guidance on issues relating to Medicare reimbursement for
dialysis services, please contact the authors or any other member of the firm’s