2006 proposed fee schedule - American Society of Clinical Oncology

Calendar Year 2005 final rule in the Federal Register
(69 FR 66319), revising payments to ESRD facilities in
accordance with provisions of the MMA. This final rule
implemented section 1881(b) of the Act, as amended by
122
section 623 of the MMA, which directed the Secretary to make
a number of revisions to the composite rate payment system,
as well as payment for separately billable drugs furnished
by ESRD facilities. Changes that were implemented
January 1, 2005 included a revision to payments for drugs
billed separately by ESRD facilities whereby the top ten
ESRD drugs are paid based on acquisition costs (as
determined by the Office of Inspector General (OIG))and
other separately billed drugs are paid average sales price
(ASP) +6 percent.
Also, in accordance with section 623 of the MMA, an
adjustment of 8.7 percent was made to the composite payment
rate to account for the difference between previous payments
for separately billed drugs and biologicals and the revised
pricing that took effect January 1, 2005. As required by
section 623 of the MMA, we are proposing to update this add-
on adjustment to reflect changes in ESRD drug utilization.
In addition, we are proposing to revise the add-on
adjustment to reflect the methodology we will be using for
ESRD drugs.