Federal Register - July 9, 2021
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Source: Federal Register
Federal Register / Vol. 86, No. 129 / Friday, July 9, 2021 / Proposed Rules
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TABLE 20: Accounting Statement: Classification of Estimated Transfers and Costs/Savings ESRD PPS and AKI CY 2022
Category Transfers Annualized Monetized Transfers $110 million From Whom to Whom Federal government to ESRD providers Category Transfers Increased Beneficiary Co-insurance Payments $30 million From Whom to Whom Beneficiaries to ESRD providers ESRD QIP for PY 2024
Category Transfers -$1 7 million Annualized Monetized Transfers From Whom to Whom Federal government to ESRD providers.
ESRD QIP for PY 2025
Category Transfers -$1 7 million Annualized Monetized Transfers From Whom to Whom Federal government to ESRD providers ETC Model for Jan 1, 2023 through June 30, 2027
Impacts of Changes in the Proposed Rule Category Transfers Annualized Monetized Transfers -$1.27 million From Whom to Whom Federal government to ESRD facilities and Managing Clinicians
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D. Regulatory Flexibility Act Analysis RFA
The Regulatory Flexibility Act RFA
requires agencies to analyze options for regulatory relief of small entities, if a rule has a significant impact on a substantial number of small entities. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and small governmental
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jurisdictions. Approximately 11 percent of ESRD dialysis facilities are considered small entities according to the Small Business Administrations SBA size standards, which classifies small businesses as those dialysis facilities having total revenues of less than $41.5 million in any 1 year.
Individuals and states are not included in the definitions of a small entity. For more information on SBAs size standards, see the Small Business Administrations website at http
www.sba.gov/content/small-business-
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size-standards Kidney Dialysis Centers are listed as 621492 with a size standard of $41.5 million.
When viewed as individual entities, as opposed to being a part of an LDO, there are approximately 643 12
percent of total number of ESRD
facilities ESRD facilities that provide fewer than 4,000 treatments per year.
With a low volume payment adjustment, each facility generates revenue from dialysis treatments of $1.26 million per year per facility. This is shown in the Table 21.
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In accordance with the provisions of Executive Order 12866, this proposed rule was reviewed by the Office of Management and Budget.
