2006 proposed fee schedule - American Society of Clinical Oncology

expenditures for all ESRD facilities. This is shown in
column 4 of Table 37 in Section V. (Regulatory Impact
174
Analysis) of this proposed rule. In aggregate the change to
all ESRD facilities would be 0.0 percent. The distributive
effect of the revised ESRD wage index can be seen in the
various impact table groupings in column 4 of Table 37 in
Section V. of this proposed rule.
Another element of the proposed transition policy would
be a proposed wage index floor of 0.8500. Using the method
described above to compute the budget neutrality factor,
makes it necessary to apply the budget neutrality factor to
this floor which would result in a proposed adjusted floor
of 0.8696.
(6) Transition Examples
In the following examples, we show the application of
revised wage adjusted composite payment rates during the
proposed two year transition period:
• Example 1--Neighborhood Dialysis Center is an
independent dialysis facility located in Baltimore County,
Maryland. As the Crosswalk Table (see addendum F) reveals,
Baltimore County was previously classified as part of the
Baltimore MSA, and is still classified as an urban county
under the new CBSA classification system. The current wage-
adjusted composite payment rate for Neighborhood Dialysis
Center is $134.93.