United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2004-06-25 monographic deposited born digital 46 p. GA 1.13:GAO-04-450 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-04-450 P0b002ee1803a3136 f:d04450 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-04-450 machine generated eng fdlp REPORT GAOREPORTS-GAO-04-450 GAO-04-450 Beneficiaries Health care costs Health care facilities Health care programs Health care services Health insurance Patient care services Payments Urologic diseases Dialysis Medicare Program Other Written Product A10617 Medicare covers about 90 percent of patients with end-stage renal disease (ESRD), the permanent loss of kidney function. Most ESRD patients receive regular hemodialysis treatments, a process that removes toxins from the blood, at a dialysis facility. A small percentage dialyzes-at home. From 1991 through 2001, the ESRD patient population more than doubled, from about 201,000 to 406,000. As the need for services grows, so do concerns about beneficiary access to and Medicare payment for dialysis services. The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 directed GAO to study beneficiaries' access to dialysis services. In this report, GAO (1) assessed the supply of dialysis facilities and the services they provide, overall and relative to beneficiary residence, and (2) assessed the extent to which Medicare payments for dialysis services are adequate and the methodology is appropriate. In order to assess the supply of dialysis facilities, GAO used Facility Surveys collected by the Centers for Medicare & Medicaid Services (CMS) and outpatient claims, the bills submitted to Medicare by providers of certain outpatient services from 1998 through 2001. To assess the adequacy of Medicare payment and the appropriateness of the payment methodology, GAO used 2001 Medicare cost reports and outpatient claims submitted by freestanding dialysis facilities. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-04-450/html/GAOREPORTS-GAO-04-450.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-04-450/pdf/GAOREPORTS-GAO-04-450.pdf GAO-04-450 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-04-450 Other Written Product GAO-04-450; Medicare Dialysis Facilities: Beneficiary Access Stable and Problems in Payment System Being Addressed; Beneficiaries Health care costs Health care facilities Health care programs Health care services Health insurance Patient care services Payments Urologic diseases Dialysis Medicare Program Volume 95 Page 357 95 Stat. 357 Volume 111 Page 251 111 Stat. 251 Volume 114 Page 2763 Volume 114 Page 2763A-517 114 Stat. 2763 114 Stat. 2763A-517 Volume 117 Page 2066 117 Stat. 2066 Public Law 105-33 Public Law 108-173