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120174 1 (1979-04-03)

handle is hein.gao/gaobacxve0001 and id is 1 raw text is: -- '4 i: ?UNITED STATES GENERAL ACCOUNTING OFFICE WASHINGTON, D.C. 20548 HUMAN RESOURCES DIVISION April 3, 1979 Mr. Leonard Schaeffer, Administrator Health Care Financing Administration Department of Health, Education, and ( & Welfare Dear Mr. Schaeffer: lie have recently completed a survey of the implementation of reimbursement procedures for outpatient dialysis treatments under the end stage renal disease program/under Medicare. The Social Security Amendments of 1972 (Public Law 92-603,venacted on October 30, 1972) authorized the program and mandated thtit be oper- ational by July 1, 1973. At the time of enactment, little data was avail- able on the cost of providing renal dialysis treatments and, therefore, to have the program operational by July 1, interim reimbursement rates were established which are still in effect. Over the years the Med gargBBg au has_made efforts to collect cost data which would serve s a basis for modifying the interim rates, if deemed necessary, The Bureau's efforts, however, have been hampered by court challengesiLto HEW's authority to collect cost data by the free- standing non-provider renal dialysis facil.jties.. On June 13, :978, Public Law 95-292 was enacted and specifically spelled out HEW's authority to collect cost data. The law stated that the Secretary of HEW was^to prescribe by regulation the methods and procedures to determine the costs incurred by providers of services and the non-provider renal dialysis facilities. The legislation further provided that the Secretary was to have in place by July 1, 1979, an incentive reimbursement system for such providers and facilities. The reimbursement rate (or rates) developed under the system are to be applied to a facility's or provider's first accounting period which begins on or after the July 1 date. After the enactment of Public Law 95-292, most renal dialysis facilities have submitted cost data. However, because the Medicare Bureau did not-promptly-establish cost reporting stantairs such as the Medicare cost reimbursement principles, for cost reporting, (HIM-15) the validity /p J7 f 120174 -, n

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