2006 proposed fee schedule - American Society of Clinical Oncology

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costs are reasonable and allowable under the relevant cost
reimbursement principles of part 413 and that its per
treatment costs in excess of its payment rate would be
directly attributable to any of the following criteria:
● Pediatric patient mix, as specified in §413.184.
● Self-dialysis training costs in pediatric
facilities, as specified in §413.186.
In the future, pediatric facilities would file for an
exception under the proposed revised exception criteria in
revised §413.184 (Payment exception: Pediatric patient mix)
and redesignated §413.190 (Payment exception: Self-dialysis
training costs in pediatric facilities). (We are proposing
to revise §413.190 and redesignate it as §413.186, see
discussion below.).
(3) Proposed Revisions to §413.184 (Payment exception:
Atypical service intensity (patient mix)
Because only pediatric ESRD facilities (those with at
least a 50 percent patient mix) may qualify for an exception
rate, we are proposing to rename §413.184 to read, “Payment
exception: Pediatric patient mix”. We also propose to
revise paragraph (a) of this section to specify that to
qualify for an exception to its prospective payment rate
based on its pediatric patient mix, a facility would be
required to demonstrate that--