August 1, 201 3
Honorable Marilyn Tavenner Administrator Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1 850
Dear Administrator Tavenner:
We write to express our concerns about the Centers for Medicru·e & Medicaid Services (CMS) recently proposed rule on the End-Stage Renal Disease (ESRD) Prospective Payment System.
The new bundled payment system for dialysis has been a remarkable success in payment ref01m. However, as written, the new proposed rule would have a devastating impact on Medicare beneficiaries who desperately depend on dialysis treatments just to stay alive.
The proposed cut in payn1 ents in the pending rule constitute a 12% or a $30 reduction of what would otherwise be $246 prospecti ve payment for dialysis. A cut of this magnitude to an industry that, according to the Medicare Payment Advisory Commission, has just 3-4% Medicare margins, could result in closure of dialysis facilities and a reversal of many recent gains that have been made in improving quality of care and mortality for dialysis pati ents.
It is our concern that CMS has not considered its fu ll statutory obligations in developing this proposal; it is c1itical to take analyze the costs of providing dialysis care. As you are aware, CMS has an obligati on to link the payment rate to facility costs or other economic and equitable factors. As you move toward finalizing the rule, we hope that the Agency will consider the full impact of the proposed changes in order to ensure that the fi nal payment amount is not less than the cost of providing care.
Again, the new bundled payment system for dialysis shows the great strides we have made, ar1d can make again. We should not let the next rule negatively impact beneficiaries who rely on these critical services. Thrulk you fo r your considerati on of our comments.
Sincerely,
Diane Black ew1s Member of Congress 2'of Congress.
Ben Ray ~ Member of Congress
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