Recalculating dialysis payments
Bundled dialysis payments targeted in latest deal
Less than one month after the Government Accountability Office called on the CMS to recalculate payments to dialysis providers, the fiscal cliff compromise sets in motion cuts that would squeeze out $4.9 billion in savings.
The Dec. 7 GAO report argued that Medicare has been overpaying for end-stage renal disease treatment by relying on 5-year-old drug use trends that are no longer accurate.
Yet the cuts run even deeper than the GAO’s calculations, which estimated that the CMS could have saved between $650 million and $880 million in 2011 if the payments were more in line with current prescribing trends.
The debate over bundled payments dovetails with an ongoing controversy about the safety of a key group of drugs known as erythropoietin-stimulating agents. The blockbuster products—including Amgen’s Epogen and Aranesp well as Johnson & Johnson’s Procrit—represent Medicare’s single-largest drug expenditure.
ESAs treat anemia that often results from kidney disease. But after they were linked to blood clots, stroke and heart attacks, the Food and Drug Administration in June 2011 changed its prescribing guidelines to