About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

HRD-85-14 1 (1985-02-01)

handle is hein.gao/gaobabexe0001 and id is 1 raw text is: BY THE US. GENERAL ACCOUNTING OFFICE Report To The Secretary Of Health And Human Services Changes Needed In Medicare Payments To Physicians Under The End Stage Renal Disease Program Since July 1973, the Medicare program has covered the cost of treating individuals with end stage renal disease. Total program costs have increased from about $229 million in 1974 to more than $1.8 billion in 1983. Renal physicians receive a monthly capitation payment for the routine outpatient care they provide to dialysis patients. The formula used to compute the monthly payment overstates physicians' involvement with home dialysis patients when compared with facility patients, resulting in higher monthly rates and additional annual program costs of about $11.8 million. Special dialysis procedure codes were established for inpatient hospital care, including hospital dialysis visits. Medicare allowances for these visits are considerably higher than those for regular hospital visits, even though the services provided are essentially the same. GAO believes that use of these special codes should be limited. GAO also believes that a system which pays for outpatient care on the basis of a monthly capitation payment and for inpatient care on a fee-for-service basis is difficult to administer. Adopting a total capitation payment system covering both routine inpatient and outpatient services would be easier to administer and, based on 1981 data, could save about $1.6 million annually in the nine states reviewed. 1 26125 GAO/HRD-85-14 1Ccous;\O l1| FEBRUARY 1, 1985

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most