2006 proposed fee schedule - American Society of Clinical Oncology

the Medicare Geographic Classification Review Board for
hospital reclassification, the Congress directed the
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Secretary to create guidelines for “determining whether the
county in which the hospital is located should be treated as
being a part of a particular [MSA]”. (See sections
1886(d)(10)(A) and (D)(i)(II) of the Act.) The Congress has
accepted the use of MSAs as a reasonable basis for dividing
the nation into labor market areas for purposes of Medicare
payments. Accordingly, we are proposing to revise the ESRD
composite payment system labor market areas based on OMB’s
geographic designations. Facilities located in counties
within MSAs (including those in the MSA category of CBSA)
would be classified as urban. We are proposing that
facilities located in Micropolitan Areas (the other category
of CBSA) or in other counties outside of CBSAs in each
State, would be considered rural.
e. Revised OMB Geographic Areas
In the following sections we discuss the classification
of facilities located in New England MSAs, within
Metropolitan Divisions of MSAs, and our proposed treatment
of the CBSA classification of Micropolitan Areas.
(1) New England MSAs
Under the current composite payment system, urban areas
in New England reflect county-based locales known as New
England County Metropolitan Areas (NECMAs), rather than