2006 proposed fee schedule - American Society of Clinical Oncology

2006) including the 8.9 percent drug add-on amount to
350
spending under current payments for drugs with the current
drug add-on of 8.7 percent. In order to make column 5
comparable with rest of Table 38, current composite rate
payments to ESRD facilities were included in both current
and proposed spending calculations.
We did not simulate any case mix in this impact table
because 2004 claims data do not include the new data fields
(height and weight) that are needed to calculate case mix.
These data fields were not required be reported by providers
until January 1, 2005. However, we have not proposed any
changes to case mix for calendar year 2006.
Column 6 shows the overall effect of all changes in
drug and composite rate payments to ESRD providers. The
overall effect is measured as the difference between
proposed payment with all MMA changes as proposed in this
rule and current payment. Proposed payment is computed by
multiplying the composite rate for each provider (with both
the proposed wage index and the 8.9 percent drug add-on)
times dialysis treatments from 2004. In addition, the
proposed payment includes payments for separately billable
drugs under the ASP +6 drug pricing inflated to 2006 levels.
Current payment is the current wage adjusted composite rate
for each provider times dialysis treatments from 2004 claims