2006 proposed fee schedule - American Society of Clinical Oncology

Under the CBSA definitions, there are 11 MSAs
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containing Metropolitan Divisions: Boston; Chicago; Dallas;
Detroit; Los Angeles; Miami; New York; Philadelphia; San
Francisco; Seattle; and Washington, DC. We believe that
these MSAs may be too large to accurately reflect the local
labor costs prevailing within each of these areas. For
example, the Chicago-Naperville-Joliet IL-IN-WI MSA consists
of 14 counties classified among 3 Metropolitan Divisions:
Chicago-Naperville-Joliet IL (8 counties); Lake
County-Kenosha County IL-WI (2 counties); and Gary IN (4
counties). Similarly, the New York-Newark-Edison NY-NJ-PA
MSA consists of 23 counties classified among 4 Metropolitan
Divisions: New York-Wayne-White Plains NY-NJ (11 counties);
Newark-Union NJ-PA (6 counties); Edison NJ (4 counties); and
Suffolk County-Nassau County NY (2 counties). Accordingly,
for the 11 MSAs with Metropolitan Divisions, we are
proposing to use the Metropolitan Division as the urban area
for purposes of constructing the wage index and applying
revised composite payment rates.
We believe that the proposed use of Metropolitan
Divisions would result in a more accurate adjustment
accounting for local variation in labor costs within each of
the 11 MSAs with those Divisions. We are proposing to
recognize each county-based Metropolitan Division within the
11 affected MSAs as a separate urban area for purposes of