Comments on HHS Proposal To Revise End Stage Renal Disease Facility Payment Rates

HRD-86-126BR: Published: Jul 22, 1986. Publicly Released: Jul 22, 1986.

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In response to a congressional request, GAO reviewed: (1) the Department of Health and Human Services Health Care Financing Administration's (HCFA) proposed revisions to Medicare's payment rates for facilities participating in the End Stage Renal Disease (ESRD) program; (2) a critique of the proposal; and (3) other public comments on the proposal.

GAO noted that the critique of the proposal and the public comments focused on: (1) the age of the data HCFA used to compute the proposed rates; (2) the use of audited cost data, which removed a substantial portion of the costs reported by independent ESRD facilities; (3) a change in the method of weighing cost data from a per-facility basis to a number-of-treatments-provided basis; (4) the source of the data used to establish costs for patients who dialyze at home; and (5) the adequacy of the data on the effects of the ESRD facility rates set in 1983 on access to and quality of care. GAO found that HCFA: (1) used the most recent data available to develop the proposed rates; (2) used the data properly; and (3) cited data showing that the proposed rate revisions would not adversely affect facility access or quality.

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