Page:United States Statutes at Large Volume 92 Part 1.djvu/364

 92 STAT. 310

Agreements.

Records.

Target reimbursement rate.

PUBLIC LAW 95-292—JUNE 13, 1978 "(B) on a comprehensive monthly fee or other basis for an aggregate of services provided over a period of time (as defined in regulations). "(4) Pursuant to agreements with approved providers of services and renal dialysis facilities, the Secretary may make payments to such providers and facilities for the cost of home dialysis supplies and equipment and self-care home dialysis support services furnished to patients whose self-care home dialysis is under the direct supervision of such provider or facility, on the basis of a target reimbursement rate (as defined in paragraph (6)). "(5) An agreement under paragraph (4) shall require, in accordance with regulations prescribed by the Secretary, that the provider or facility will— "(A) assume full responsibility for directly obtaining or arranging for the provision of— "(i) such medically necessary dialysis equipment as is prescribed by the attending physician; "(ii) dialysis equipment maintenance and repair services; "(iii) the purchase and delivery of all necessary medical supplies; and " (iv) where necessary, the services of trained home dialysis aides; "(B) perform all such administrative functions and maintain such information and records as the Secretary may require to verify the transactions and arrangements described in subparagraph (A); . ., "(C) submit such cost reports, data, and information as the Secretary may require with respect to the costs incurred for equipment, supplies, and services furnished to the facility's home dialysis patient population; and "(D) provide for full access for the Secretary to all such records, data, and information as he may require to perform his functions under this section. "(6) The Secretary shall establish, for each calendar year, commencing with January 1, 1979, a target reimbursement rate for home dialysis which shall be adjusted for regional variations in the cost of providing home dialysis. In establishing such a rate, the Secretary shall include— " (A) the Secretary's estimate of the cost of providing medically necessary home dialysis supplies and equipment; "(B) an allowance, in an amount determined by the Secretary, to cover the cost of providing personnel to aid in home dialysis; and "(C) an allowance, in an amount determined by the Secretary, to cover administrative costs and to proAade an incentive for the efficient delivery of home dialysis; but in no event shall such target rate exceed 70 percent of the national average payment, adjusted for regional variations, for maintenance dialysis services furnished in approved providers and facilities during the preceding fiscal year. Any such target rate so established shall be utilized, without renegotiation of the rate, throughout the calendar year for which it is established. During the last quarter of each calendar year, the Secretary shall establish a home dialysis target reimbursement rate for the next calendar year based on the most recent data available to the Secretary at the time. In establishing any rate under this paragraph, the Secretary may utilize a competitive-bid procedure, a prenegotiated rate procedure, or any other procedure

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