2006 proposed fee schedule - American Society of Clinical Oncology

● Adding a definition of a “pediatric facility” (in
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accordance with section 422(a)(2)of BIPA 2000, as amended by
section 623(b) of the MMA) to mean a renal facility at least
50 percent of whose patients are individuals under 18 years
of age;
● Removing existing exception criteria that are no
longer applicable; and
● Adjudicating future exception requests in accordance
with the proposed revised exception criteria.
(1) Proposed Revisions to §413.180 (Procedures for
requesting exceptions to payment rates)
In response to the changes made by section 422 of BIPA
2000 and section 623 of MMA, we are proposing significant
changes to the existing regulations at §413.180 through
§413.192 regarding ESRD exception criteria and application
procedures. Under our current regulations, existing
exception rates that were approved prior to
December 31, 2000 (or those approved during the window that
closed on July 1, 2001) would remain in effect as long as
the conditions under which the exception was granted have
not changed and as long as the facility files a request to
retain the exception rate with its fiscal intermediary
during the 30-day period before the opening of an exception
cycle (and the request is approved by the fiscal
intermediary.) Even though pediatric exceptions are not