2006 proposed fee schedule - American Society of Clinical Oncology

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than 0.9000 are paid more than they would otherwise receive
if we fully adjusted for area wage differences. Conversely,
facilities in locales with wage index values greater than
1.3000 are paid less than they would receive if we fully
adjusted the rates based on actual wage levels.
Section 1881(b)(12)(D) of the Act, as amended by
section 623(d) of the MMA, gave the Secretary the
discretionary authority to revise the current wage index.
That provision also requires that any revised measure be
phased-in over a multiyear period. In the November 15, 2004
final rule establishing new case-mix adjusted composite
payment rates (69 FR 66332), we stated that we were
deferring replacing the current wage index pending further
assessment. We have completed our review, and believe that
modernizing the current ESRD wage index is a matter of some
urgency. After further analysis we are proposing to use
OMB’s revised geographic definitions announced in OMB
Bulletin No. 03-04, issued June 6, 2003. These new
definitions are known as Core-Based Statistical Areas
(CBSAs). In conjunction with the CBSAs, we are also
proposing to recalculate the ESRD wage indexes based on
acute care hospital wage and employment data for FY 2002, as
reported to us in connection with the development of the
wage index used in the inpatient hospital prospective
payment system (IPPS). In addition, we are also proposing