2006 proposed fee schedule - American Society of Clinical Oncology

distributed this over a total projected 34.5 million
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treatments resulting in a revised CY 2005 add-on to the per
treatment composite rate of 8.1 percent. By making this
adjustment to the composite rate, we estimate that the
aggregate payments to both independent and hospital-based
ESRD facilities would be budget neutral with respect to drug
payments for CY 2005, as required by the MMA. We note that
this 8.1 percent adjustment replaces the current 8.7 percent
adjustment for CY 2005 in our calculations.
b. Calculation of the Proposed CY 2006 Update to the Drug
Add-On Adjustment
This section describes the approach that we are
proposing to use to update the drug add-on adjustment.
(1) Drug Payments and Dialysis Treatments
Similar to the process discussed in the previous
section, we updated the total aggregate Epogen drug payments
for each hospital-based and independent facility using
historical trend factors. For CY 2006, the payment level
was increased from CY 2005 by a trend factor of 9.0 percent.
We also updated aggregate spending for separately billable
drugs, other than EPO, for independent facilities using the
9 percent growth factor for Epogen. As discussed earlier,
payments in this category have shown extremely varied growth
in recent history and historical data between CY 2002 and
CY 2003 showed a significant drop in aggregate spending. We