2006 proposed fee schedule - American Society of Clinical Oncology

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Section 623 of the MMA also required the establishment
of basic case-mix adjustments to the composite payment rate
for a limited number of patient characteristics. The
November 15, 2004 final rule implemented three categories of
patient characteristic adjustments (age, low body mass index
(BMI), and body surface area (BSA)) that were implemented
April 1, 2005. We are proposing to maintain these
categories and patient characteristics as established in the
November 15, 2004 final rule (69 FR 66238).
Also, section 1881(b)(12)of the Act as amended by
section 623 of the MMA provided authority to revise the
geographic adjustment applied to the composite payment rate.
Accordingly, we are proposing to revise the geographic
classifications and wage indexes currently in effect for
adjusting composite rate payments. As required by section
623 of the MMA, these proposed changes will be phased in
over time.
In addition, we are proposing revisions to the
regulations applicable to the composite rate exceptions
process to reflect section 623 of the MMA provisions that
restrict exceptions to pediatric facilities.
1. Revised Pricing Methodology for Separately Billable
Drugs and Biologicals Furnished by ESRD Facilities