2006 proposed fee schedule - American Society of Clinical Oncology

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MSAs. We use NECMAs in New England to provide consistency
in labor market definitions compared to the MSAs used in the
rest of the country, which are also based on counties.
Under the new CBSAs, OMB has defined MSAs and Micropolitan
Areas in New England on the basis of counties. OMB has also
established a new classification, New England City and Town
Areas (NECTAs), which are similar to the previous New
England MSAs, but which are not used in the geographic area
revisions proposed in this proposed rule.
In the interest of consistency among all urban labor
market areas, we are proposing to use the county-based
definitions for all MSAs in the nation. As a result of the
2000 Census, we now have county-based MSAs in New England.
We believe that adopting county-based definitions for all
urban areas in the country provides consistency and
stability, and minimizes administrative complexity in the
Medicare program. We point out that our use of MSAs in
New England comports with the implementation of the CBSA
designations under the IPPS for New England urban locales.
(See the August 11, 2004 Federal Register, 69 FR 49208.)
Accordingly, under the revised composite payment rates
discussed in this proposed rule, we are proposing to use New
England MSAs along with MSAs in the rest of the nation to
define urban areas. As a result, urban locales in
New England would no longer be based on NECMAs.