The dialysis devices maker submitted a public comment on the updated rule, calling for more support for HHD therapy, especially in terms of training.
"The status quo is inconsistent with the Congressional mandate to bring patients home and is a huge factor in Medicare [end stage renal disease] patients’ limited access to more frequent HHD," NxStage Medical North America president Joe Turk said in prepared remarks. "This issue can and should be addressed to allow patients better access to this life-changing therapy, that so often leads to longer, healthier lives for patients who require dialysis to live."
Turk has called out CMS before, chastising the agency for what he perceives as a lack of support for HHD for Medicare patients with kidney failure, despite a growing consensus among private insurers that the procedure is "medically necessary" for some.
CMS in July issued an updated rule for reimbursement of HHD treatment that wasn’t much of an update at all. CMS maintained the reimbursement status quo, dashing NxStage Medical’s hopes of a more favorable physician payment environment – as well as some investors’ hopes of a near-term upside for NxStage Medical.
The CMS rule maintained reimbursement rates for at-home hemodialysis, which was already 20% lower than offered for in-clinic dialysis.
In a letter glibly titled “Really?”, posted on the company website last month, Turk outlined his disappointment in the policy as proposed, offered a few quick fixes and urged stakeholders to submit suggestions on the rule during the open comment period – before the proposal becomes policy.
NxStage submitted its own official comment late last month, asking for 3 changes to the rule as proposed: updated baseline payment for HHD training, removal of an "artificial discrepancy" that limits reimbursement to 3 training sessions per week and an update mechanism for training costs to account for inflation.
"NxStage believes that the current payment methodology for HHD training represents an inadvertent injustice to patients, and is a significant contributor to the restricted access that is evident in the ESRD population," according to the company’s comment. "We were surprised that this was not addressed in this year’s proposed rules: CMS indicated last year in the Final Rule with Comments for 2012 that the add-on for home dialysis training would be revisited in subsequent rulemaking, but this issue remains unresolved."
NXTM shares have swung back and forth in recent weeks as investors digest the proposal. Shares hit a new low early in August when the company released its latest earnings report, which included record sales and a forecast-beating 2nd quarter.
Shares jumped 4.4% today, trading at $13.38 as of about 12:30 p.m.