2006 proposed fee schedule - American Society of Clinical Oncology
2006 proposed fee schedule - American Society of Clinical Oncology 2006 proposed fee schedule - American Society of Clinical Oncology
practices, data collected or developed by entities and organizations to supplement the data we normally collect in determining the PE component. On May 3, 2000, we published the interim final rule (65 FR 25664) that set forth the criteria for the submission of these supplemental PE survey data. The criteria were modified in response to comments received, and published in the Federal Register (65 FR 65376) as part of a November 1, 2000 final rule. The PFS final rules published in 2001 and 2003, respectively, (66 FR 55246 and 68 FR 63196) extended the period during which we would accept these supplemental data. 3. Resource-Based Malpractice RVUs Section 4505(f) of the BBA amended section 1848(c) of the Act to require us to implement resource-based malpractice RVUs for services furnished on or after 2000. The resource–based malpractice RVUs were implemented in the PFS final rule published November 2, 1999 (64 FR 59380). The malpractice RVUs were based on malpractice insurance premium data collected from commercial and physician-owned insurers from all the States, the District of Columbia, and Puerto Rico. 4. Refinements to the RVUs Section 1848(c)(2)(B)(i) of the Act requires that we review all RVUs no less often than every five years. The first 5-year review of the physician work RVUs went into 20
effect in 1997, published on November 22, 1996 (61 FR 59489). The second 5-year review went into effect in 2002, published on November 1, 2001 (66 FR 55246). The next scheduled 5-year review is scheduled to go into effect in 2007. In 1999, the AMA’s RUC established the Practice Expense Advisory Committee (PEAC) for the purpose of refining the direct PE inputs. Through March of 2004, the PEAC provided recommendations to CMS for over 7,600 codes (all but a few hundred of the codes currently listed in the AMA's Current Procedural Terminology (CPT) codes). In the November 15, 2004, PFS final rule (69 FR 66236), we implemented the first 5-year review of the malpractice RVUs (69 FR 66263). 5. Adjustments to RVUS are Budget Neutral Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs for a year may not cause total PFS payments to differ by more than $20 million from what they would have been if the adjustments were not made. In accordance with section 1848(c)(2)(B)(ii)(II) of the Act, if adjustments to RVUs cause expenditures to change by more than $20 million, we make adjustments to ensure that expenditures do not increase or decrease by more than $20 million. 21
- Page 1 and 2: DEPARTMENT OF HEALTH AND HUMAN SERV
- Page 3 and 4: 2. By mail. You may mail written co
- Page 5 and 6: Rick Ensor (410) 786-5617 (for issu
- Page 7 and 8: service of the U.S. Government Prin
- Page 9 and 10: 4. Proposed Revisions to §413.170
- Page 11 and 12: AGA American Gastroenterological As
- Page 13 and 14: GAO General Accounting Office GPCI
- Page 15 and 16: PLI Professional liability insuranc
- Page 17 and 18: Initially, only the physician work
- Page 19: This resource-based system was base
- Page 23 and 24: ● Revised requirements for superv
- Page 25 and 26: efinement of work RVUs; and solicit
- Page 27 and 28: historical allowed charges. This le
- Page 29 and 30: November 1, 2001 (66 FR 55246).) Th
- Page 31 and 32: The CPEPs identified specific input
- Page 33 and 34: codes that the RUC has not yet revi
- Page 35 and 36: procedure: $27,305,408. In this exa
- Page 37 and 38: as a whole. Indirect costs include
- Page 39 and 40: ● The unscaled indirect expense a
- Page 41 and 42: BNF is applied to (multiplied by) t
- Page 43 and 44: NPWP Step 2--Calculation of Charge-
- Page 45 and 46: In Table 11, the scaled total direc
- Page 47 and 48: TABLE 13--Budget Neutrality and Fin
- Page 49 and 50: The following discussion outlines t
- Page 51 and 52: exist, and suggests that the need f
- Page 53 and 54: TABLE 14--Practice Expense Per Hour
- Page 55 and 56: We believe that we have consistentl
- Page 57 and 58: Due to the ongoing refinement by th
- Page 59 and 60: indirect PE methodology is inaccura
- Page 61 and 62: multi-specialty PEAC that were base
- Page 63 and 64: the needed survey or other data or
- Page 65 and 66: PERC/RUC recommendations for these
- Page 67 and 68: eflect the typical number of cast c
- Page 69 and 70: on comments received and additional
practices, data collected or developed by entities and<br />
organizations to supplement the data we normally collect in<br />
determining the PE component. On May 3, 2000, we published<br />
the interim final rule (65 FR 25664) that set forth the<br />
criteria for the submission <strong>of</strong> these supplemental PE survey<br />
data. The criteria were modified in response to comments<br />
received, and published in the Federal Register (65 FR<br />
65376) as part <strong>of</strong> a November 1, 2000 final rule. The PFS<br />
final rules published in 2001 and 2003, respectively,<br />
(66 FR 55246 and 68 FR 63196) extended the period during<br />
which we would accept these supplemental data.<br />
3. Resource-Based Malpractice RVUs<br />
Section 4505(f) <strong>of</strong> the BBA amended section 1848(c) <strong>of</strong><br />
the Act to require us to implement resource-based<br />
malpractice RVUs for services furnished on or after 2000.<br />
The resource–based malpractice RVUs were implemented in the<br />
PFS final rule published November 2, 1999 (64 FR 59380).<br />
The malpractice RVUs were based on malpractice insurance<br />
premium data collected from commercial and physician-owned<br />
insurers from all the States, the District <strong>of</strong> Columbia, and<br />
Puerto Rico.<br />
4. Refinements to the RVUs<br />
Section 1848(c)(2)(B)(i) <strong>of</strong> the Act requires that we<br />
review all RVUs no less <strong>of</strong>ten than every five years. The<br />
first 5-year review <strong>of</strong> the physician work RVUs went into<br />
20
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