For a second time, the Centers for Medicare & Medicaid Services (CMS) Innovation Center has extended the deadlines for both Letters of Intent and applications for its Comprehensive End-Stage Renal Disease (ESRD) Care Initiative. Based on a high level of interest and requests for additional time to prepare applications, CMS will now accept letters of intent until July 19, 2013, and accept applications until August 1, 2013. Medicare beneficiaries with ESRD have significant care needs, and the purpose of the initiative is to test and assess a new model of payment and care delivery for these patients in order to improve health outcomes and access to services, as well as reduce per-capita expenditures. Fifteen ESRD Seamless Care Organizations (ESCOs) will be selected to assist in evaluating the effectiveness of this model over a five-year period. Eligible applicants must serve a minimum of 500 patients and include Medicare Certified dialysis facilities, nephrologists/nephrology practices, and other Medicare providers and suppliers.