2006 proposed fee schedule - American Society of Clinical Oncology

and one for independent facilities during the transition
from the current wage adjustments to the revised wage
adjustments.
In order to compute the proposed wage index budget
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neutrality adjustment factor, we used treatment counts from
the CY 2004 billing data and facility-specific 2005
composite payment rates. We note that this file is
currently only about 85 percent complete. For the final
rule, we expect to use the most complete CY 2004 file
available. Using the CY 2004 billing data, we first
computed the estimated total dollar amount that ESRD
facilities would have received in CY 2006 had there been no
changes to the ESRD wage index. This amount becomes the
estimated target amount of expenditures for all ESRD
facilities. Then we computed the estimated dollar amount
that would be paid to the same ESRD facilities using the
revised ESRD wage index. After comparing these two dollar
amounts, we calculate an adjustment factor to the ESRD wage
index as the factor that when multiplied by the revised ESRD
wage index will result in the target amount of expenditures
for all ESRD facilities. Since the revised wage index
values are only applied to the labor-related portion of the
composite payment rate, we computed the adjustment based on
that proportion (that is, 53.711 percent). We applied the
estimated budget neutrality adjustment factor to the revised