federal_register: 01-24494
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| document_number | title | type | abstract | publication_date | pub_year | pub_month | html_url | pdf_url | agency_names | agency_ids | excerpts |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 01-24494 | Medicare Program; Revision of Payment Rates for End-Stage Renal Disease (ESRD) Patients Enrolled in Medicare+Choice Plans | Notice | This final notice establishes a new payment methodology, effective January 2002, for beneficiaries with End-Stage Renal Disease (ESRD) who are enrolled in Medicare+Choice (M+C) plans. This methodology implements section 605 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA). Section 605 requires the Secretary to increase M+C ESRD payment rates, using appropriate adjustments, to reflect the demonstration rates (including the risk adjustment methodology associated with those rates) of the social health maintenance organization (SHMO) ESRD capitation demonstrations. Briefly, the methodology set forth in this final notice-- Increases the base year rates by 3 percent to reach 100 percent of fee-for-service costs as estimated for the base year for M+C purposes (this adopts the approach used under the ESRD SHMO demonstration); and Adjusts State per capita rates by age and sex factors, in order to pay more accurately, given differences in costs among ESRD patients. The effect of the new M+C ESRD payment methodology is to increase Medicare's fiscal year (FY) 2002 M+C ESRD payments by an estimated $35 million (for 9 months of costs, given the effective date of January 2002). M+C ESRD payment increases through FY 2006 are estimated to be $55 million for FY 2003, $55 million for FY 2004, $60 million for FY 2005, and $65 million for FY 2006. The payment methodology set forth in this notice will govern M+C payments for enrollees with ESRD in 2002. | 2001-10-01 | 2001 | 10 | https://www.federalregister.gov/documents/2001/10/01/01-24494/medicare-program-revision-of-payment-rates-for-end-stage-renal-disease-esrd-patients-enrolled-in | https://www.govinfo.gov/content/pkg/FR-2001-10-01/pdf/01-24494.pdf | Health and Human Services Department; Centers for Medicare & Medicaid Services | 221,45 | This final notice establishes a new payment methodology, effective January 2002, for beneficiaries with End-Stage Renal Disease (ESRD) who are enrolled in Medicare+Choice (M+C) plans. This methodology implements section 605 of the Medicare, Medicaid,... |