In 1972 the United States Congress passed legislation authorizing the End Stage Renal Disease Program (ESRD) under Medicare.
[citation needed] The composite rate is intended to cover all operating and capital costs that efficient providers would incur in furnishing dialysis in outpatient facilities or in beneficiaries' homes.
Medicare caps its payments to facilities at an amount equal to three dialysis sessions per week.
The Social Security Act (Section 1881(b)), as amended by Section 623 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, directed revisions to the composite rate payment system as well as payment for separately billable drugs furnished by dialysis facilities.
The EGHP is primary regardless of the number of employees and/or the Medicare beneficiary's employment status.