2006 proposed fee schedule - American Society of Clinical Oncology

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We also note MedPAC’s recommendation in its June 2005
report that the ASP be the basis of payment for all
separately billable ESRD drugs provided by both freestanding
and hospital-based facilities in CY 2006 (MedPAC, “Report to
the Congress: Issues in a Modernized Medicare Program,”
June 2005). In making this recommendation, MedPAC states
that the ASP data are more current (updated quarterly), and,
thus, more likely to reflect actual transaction prices,
compared with acquisition cost data which are not regularly
collected by the OIG or CMS. Furthermore, the report
indicated that utilizing the same payment policy for both
freestanding and hospital-based facilities would ensure
uniformity across the various settings irrespective of the
site of care. In addition, MedPAC recommends in its report
that we obtain, “…data to estimate hospitals’ costs and
Medicare’s payment per unit for these drugs. No published
source identifies the unit payment for these drugs because
Medicare pays hospitals their reasonable costs.” MedPAC
further states: “We attempted to calculate the unit payment
from 2003 claims data, but the accuracy of the data fields
we needed to make this calculation was unclear, particularly
the number of units furnished and Medicare’s payment to the
hospital.” MedPAC also recommends that CMS and/or OIG
collect acquisition cost data periodically in the future to