CMS rethinks roll out of CROWNweb

By Bill Peckham

RenalWEB has a Department of Health & Human Services Centers for Medicare & Medicaid Services (CMS) communication posted.

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the renal CROWNWeb system will move from its testing environment to a production/implementation environment on February 1, 2009. At that time, CMS will launch CROWNWeb to a small, select group of providers across the country—representing both large- and small-dialysis organizations, as well as independent dialysis facilities across the country. CMS will expand implementation as it learns more about how the system functions within individual facilities.

Until facilities are phased in to CROWNWeb implementation, they should continue with their normal business operations and reporting requirements, including using the SIMS, VISION, and paper-based data submissions. 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.

This is much different than the language in CMS's CROWNWeb document that was sent out in June to all dialysis facilities (pdf link) (emphasis CMS's):

The final rule requires the submission and maintenance of electronic patient and provider records for all dialysis facilities in the United States (§494.180(h)). This requirement takes effect on February 1, 2009. To support this mandate, CMS announces CROWNWeb, a web-based software application that all dialysis facilities will be required to use beginning February 1, 2009. Use of CROWNWeb for data submission by February 1, 2009 is mandatory to support CMS’s goals of quality improvement and performance assessment, as well as to ensure prompt claims processing and reimbursement.

I wrote about the problem with CMS's implementation of this mandate here, here, here and here. Today's communication from CMS suggests that before CROWNweb is rolled out nationally it will be able to accept batch data from all providers. I also note that today is the date mentioned in the December 23, 2008 letter (pdf link) which was signed by Washington State's 2 Senators and 9 Representatives. This letter was addressed to CMS's acting administrator Kerry Weems and CMS's Medical Officer Dr. Straube. The Washington State delegation's letter raised concerns with the CROWNweb implementation and asked CMS to answer by today.

Congratulations to the National Renal Administrators Association, small dialysis providers and in particular the Northwest Kidney Centers for their successful advocacy on behalf of small providers and ultimately patients. Patients win when nurses can spend their time on taking care of patients, rather than doing paper work. Thank you to Washington State's entire Congressional delegation for once again showing bipartisan support for the country's dialyzors. And kudos to CMS's acting administrator Kerry Weems and CMS's Medical Officer Dr. Straube for reconsidering the issue and taking a step back. This is good news.

EDIT 1/17/2009 The title to this post was originally CMS rethinks. Delays roll out of CROWNweb but in fact CMS has not delayed the roll out rather they have scaled it back. The CROWNweb launch is now to a "small, select group of providers" which for most intents is a delay but it will be launched on time so the original headline was incorrect.