ESRD conditions of coverage
Compliance Monitor, April 1, 2005
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Q: What sanctions might a provider face if it is not in compliance with the new Medicare end stage renal disease (ESRD) conditions of coverage?
A: The possible penalties for noncompliance include
- denial of payment for services furnished to Medicare patients first accepted for care after the effective date of the sanction
- reduction of payments for all ESRD services furnished to Medicare patients by 20% for each 30-day period after the effective date of the sanction
- withholding of all payments, without interest, for all ESRD services furnished to Medicare beneficiaries
This question was answered by Carrie L. McGinnis, RN, MBA, chief executive officer of Healthcare Design Specialists, LLC, in Springfield, MO.
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