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

19.02.2013 Views

2006, we project total Medicare revenues to oncologists would decline by 5.6 percent. However, if the volume of 342 drugs and PFS services increased at historical rates, total Medicare revenues for hematology/oncology would increase by 8.1 percent between 2005 and 2006. Specialty HEMATOLO GY/ ONCOLOGY TABLE 35--Impact of Drug and Physician Fee Schedule Payment Changes Physician Fee Schedule Drugs All Revenues % of Total Medicare Revenues from Fee Schedule % Change Medicare Physician Fee Schedule Revenues % Change One-Year Demonstration Project % of Total Medicare Revenues from Drugs % Change Medicare Drug Revenues Combined % Change All Medicare Revenues * Combined % Change All Medicare Revenues With Utilization Increase* * 28% -5.2% -15% 69% 0% -5.6% 8.1% *Note: Reflects changes in total Medicare revenues assuming no changes in utilization. Calculation reflects average changes in fee schedule payments and for drugs weighted by percent of Medicare revenues. ** Note: We estimate that Medicare payments to oncologists would increase by 8% between 2005 and 2006 if growth in the volume of drugs and physician fee schedule services were to grow at historical rates, despite the effect of the end of the one-year demonstration project. B. Geographic Practice Cost Indices (GPCI)- Payment Localities As discussed in section II.B. of the preamble to this proposed rule, we are proposing two changes to the California GPCI payment localities. We are proposing to remove both Santa Cruz County and Sonoma County from the Rest of California payment locality, and make both of those counties separate payment localities. In the November 15, 2004 final rule, we published 2005 and 2006 GPCI and GAF values reflecting the 2 year phase-in

of the updated GPCI data. For the Rest of California payment locality that included Santa Cruz and Sonoma 343 counties, the 2005 GAF is 1.012, and the 2006 GAF published at that time was 1.017. After removing Santa Cruz County from the Rest of California locality, its proposed 2006 GAF increases to 1.119. Removing Sonoma County from the Rest of California locality results in a proposed 2006 GAF of 1.098 for the new Sonoma County payment locality. The Rest of California proposed 2006 GAF is 1.011. Table 36 below shows the impacts of the proposed changes in the GPCIs and GAFs. Although only Santa Cruz and Sonoma Counties and the Rest of California locality are specifically impacted by the proposed change, in Table 36, we are showing the GPCIs and GAFs for all California payment localities (the changes from the 2005 to 2006 GAFs for these counties represent the second year of the transition to updated GPCIs).

<strong>of</strong> the updated GPCI data. For the Rest <strong>of</strong> California<br />

payment locality that included Santa Cruz and Sonoma<br />

343<br />

counties, the 2005 GAF is 1.012, and the <strong>2006</strong> GAF published<br />

at that time was 1.017. After removing Santa Cruz County<br />

from the Rest <strong>of</strong> California locality, its <strong>proposed</strong> <strong>2006</strong> GAF<br />

increases to 1.119. Removing Sonoma County from the Rest <strong>of</strong><br />

California locality results in a <strong>proposed</strong> <strong>2006</strong> GAF <strong>of</strong> 1.098<br />

for the new Sonoma County payment locality. The Rest <strong>of</strong><br />

California <strong>proposed</strong> <strong>2006</strong> GAF is 1.011. Table 36 below shows<br />

the impacts <strong>of</strong> the <strong>proposed</strong> changes in the GPCIs and GAFs.<br />

Although only Santa Cruz and Sonoma Counties and the Rest <strong>of</strong><br />

California locality are specifically impacted by the<br />

<strong>proposed</strong> change, in Table 36, we are showing the GPCIs and<br />

GAFs for all California payment localities (the changes from<br />

the 2005 to <strong>2006</strong> GAFs for these counties represent the<br />

second year <strong>of</strong> the transition to updated GPCIs).

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