A recent GAO report suggests that the bundled Medicare payment for dialysis care over-compensates dialysis facilities for end-stage renal disease (ESRD) drug costs. By way of background, the Medicare ESRD payment bundle was expanded in 2011 to include payment for injectable ESRD drugs and their oral equivalents and certain other items and services for which Medicare previously had paid separately. According to the GAO, utilization of ESRD drugs was about 23% lower on average in 2011 than in 2007, the year on which 2011 rates were based (attributed largely to a decline in the utilization of erythropoiesis stimulating agents). The GAO estimates that Medicare dialysis spending would have been $650 million to $880 million lower in 2011 if the bundled rate were rebased to reflect the 2011 utilization level of ESRD drugs, and potential savings could be even more significant in future years. According to the report, CMS does not believe that the statute provides it with explicit authority to rebase rates. The GAO therefore recommends that Congress require the Secretary of HHS to rebase the ESRD bundled payment rate as soon as possible and on a periodic basis thereafter, using the most current available data.