Sec. 5-5.08a. Renal dialysis; add-on payments for home dialysis providers in skilled nursing facilities.

263 words·~1 min read·/il/chapter-305/act-5/5-5-08a

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(a)Findings. The General Assembly finds the following:

(1)Home dialysis services provided on-site at skilled nursing facilities are beneficial

to nursing home residents by permitting more time for other health and wellness activities, and nullifying burdensome off-site travel which carries various health care risks and increased costs.

(2)Home dialysis for nursing home residents provides an on-site venue for high-acuity

residents to receive dialysis services, effectively creating downstream care opportunities for hospital patients in need of post-acute care and dialysis, and reducing the total cost of dialysis care.

(3)On-site home dialysis in nursing homes is costlier for the provider than

conventional outpatient dialysis, as labor costs are greater per treatment and such patients typically have higher acuities, necessitating more medication and greater staff involvement to promote patient compliance.

(b)Subject to federal approval, for dates of service beginning on and after January 1, 2025, for home renal dialysis provided to residents of skilled nursing facilities, the Department shall reimburse a per-claim add-on payment to certified home dialysis providers in accordance with this Section. Certified home dialysis providers providing dialysis services within a skilled nursing facility shall receive a per-claim add-on payment of $95 per treatment. As used in this Section, "certified home dialysis provider" means an end-stage renal disease facility that

(i)provides dialysis treatment or dialysis training to caregivers or individuals with end-stage renal disease and

(ii)has been approved to provide dialysis home training support services by the federal Centers for Medicare and Medicaid Services.