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Medicare Payments for Home Dialysis Services

Medicare Part B covers outpatient dialysis services for enrollees diagnosed with end-stage renal disease (ESRD). Treatments can be provided in an outpatient or home setting and must be monitored by certified ESRD facilities. Prior OIG work identified inappropriate Medicare payments for dialysis services. Specifically, OIG identified claims for which there were neither dialysis treatment notes for home dialysis sessions nor documentation of the dispensing or administration of medication billed. Additionally, OIG found claims with medication billed exceeding a physician-prescribed amount, as well as other issues with comprehensive assessments, plans of care, and physicians' monthly progress notes. We will review claims for Medicare Part B home dialysis services provided to ESRD patients to determine whether such services complied with Medicare requirements. Also, we will review the impact of home dialysis services on enrollees and whether enrollees' quality of care could be affected.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
December 2023 Centers for Medicare and Medicaid Services Medicare Payments for Home Dialysis Services Office of Audit Services WA-24-0016 (W-00-24-35908) 2024