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
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).
- Page 291 and 292: 291 conclude that Hispanic persons
- Page 293 and 294: 293 nuclear medicine services in ei
- Page 295 and 296: adiopharmaceuticals. In the final r
- Page 297 and 298: 297 (including Nuclear Medicine and
- Page 299 and 300: we would resolve any doubt on the m
- Page 301 and 302: facility payment rather than a TC c
- Page 303 and 304: ventures and leases, pose a risk of
- Page 305 and 306: 305 Underlying the projected rate r
- Page 307 and 308: decisions are central to the health
- Page 309 and 310: however. We are particularly intere
- Page 311 and 312: The collection requirement in this
- Page 313 and 314: eporting requirements are discussed
- Page 315 and 316: IV. Response to Comments Because of
- Page 317 and 318: achieve the objectives with less si
- Page 319 and 320: 319 The analysis and discussion pro
- Page 321 and 322: 321 for a new code may change becau
- Page 323 and 324: 323 TABLE 30--Impact of Practice Ex
- Page 325 and 326: hour for these specialties. As note
- Page 327 and 328: Both physical/occupational therapy
- Page 329 and 330: 329 proposing to add cardiology cat
- Page 331 and 332: Speciality Impact of Removing Aberr
- Page 333 and 334: Family TABLE 32--Impact of Multiple
- Page 335 and 336: 335 column includes the current est
- Page 337 and 338: Specialty Medicare Allowed Charges
- Page 339 and 340: 339 Non-Facility Facility % % HCPCS
- Page 341: 341 have undertaken a similar analy
- Page 345 and 346: C. Medicare Telehealth Services In
- Page 347 and 348: 347 TABLE 37--Impact of Proposed Ch
- Page 349 and 350: 349 of the increase to the drug add
- Page 351 and 352: plus current AAP priced drug paymen
- Page 353 and 354: 353 the center up to what it would
- Page 355 and 356: satisfies the requirements of the i
- Page 357 and 358: 357 certainty the extent of these s
- Page 359 and 360: delivery arrangements and would hel
- Page 361 and 362: List of Subjects 42 CFR Part 405 Ad
- Page 363 and 364: (including by refunding amounts in
- Page 365 and 366: (2) Any financial incentives provid
- Page 367 and 368: 7. The authority citation for part
- Page 369 and 370: * * * * * PART 413--PRINCIPLES OF R
- Page 371 and 372: 371 D. Redesignating paragraphs (l)
- Page 373 and 374: 373 (3) The additional nursing hour
- Page 375 and 376: cost components relating to trainin
- Page 377 and 378: CAPD and CCPD) when the facility ac
- Page 379 and 380: Indirect Sales means from the manuf
- Page 381 and 382: amount for the quarter to the neare
- Page 383 and 384: 383 25. The heading for Part 426 is
- Page 385 and 386: 385 (Catalog of Federal Domestic As
- Page 387 and 388: 1. CPT/HCPCS code. This is the CPT
- Page 389 and 390: grace period. This indicator is no
- Page 391 and 392: 5. Physician work RVUs. These are t
<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).