The Office of Inspector General (OIG), Department of Health and Human Services, has issued a proposed rule under section 5201 of the Omnibus Consolidated and Emergency Supplemental Appropriations Act for Fiscal Year 1999 (OCESAA) that would provide a safe harbor from civil sanctions under section 1128A(a)(5) of the Social Security Act for independent dialysis facilities that pay premiums for Supplementary Medical Insurance (Medicare Part B) or Medicare Supplemental Health Insurance Policies (Medigap) for financially needy Medicare beneficiaries with end-stage renal disease (ESRD).

End-stage renal disease is a chronic disease that requires regular dialysis treatments and monitoring of laboratory values, diet and medication. ESRD patients suffer from irreversible renal failure, often accompanied by diabetes, anemia, hypertension and congestive heart failure.