WASHINGTON—After mounting pressure from the renal community, Medicare will be scaling back its implementation of the CROWNWeb data reporting system, forcing only a small number of dialysis facilities to participate by Feb. 1. Meanwhile, the federal agency will study discrepancies in the system.
Federal rules released last year that govern how dialysis clinics must operate, said that on Feb. 1, 2009, all dialysis providers would be required to turn in patient information (such as events, forms and lab data) using electronic data-submission software, which will be available to facilities through a secure Internet site.
Few opposed the idea of a paperless system. However, a disparity existed between small dialysis providers and large dialysis providers, in regards to how the data must be submitted. The three largest dialysis providers in the United States would be permitted to “batch submit” the data using their existing computer programs.
On the other hand, small dialysis organizations would be required to manually enter the data through the Web site, despite having the capability to batch submit. These clinics claimed that the manual process would be an extra burden on staff and would cost extra money.
These concerns resulted in a flurry of letters to the Centers for Medicare & Medicaid Services calling for the delay in implementation.
CMS Modifies Implementation
In modifying the CROWNWeb implementation, CMS recognized the data submission discrepancy between large dialysis organizations and small providers.
CMS will still launch CROWNWeb (The Consolidated Renal Operations in a Web Enabled Network) on Feb. 1, but the release will only affect a small, select group of providers across the country, according to a Jan. 16 email from CMS.
Some of the facilities will represent large dialysis organizations—such as DaVita and Fresenius—that will batch submit data. Other facilities will include small dialysis providers and independents who will submit data manually, according to a CMS letter.
No information has been released regarding how those clinics will be chosen.
“Until facilities are phased into CROWNWeb implementation, they should continue with their normal business operations and reporting requirements, including using the SIMS, VISION and paper-based data submissions,” CMS wrote in a Jan. 16 email to providers. “Facilities that are not part of the first phase of implementation may continue to meet their requirements under the ESRD conditions for coverage by continuing to use these submission methods.”
