2006 proposed fee schedule - American Society of Clinical Oncology

dispensing fee would depend on the dispensing fee amount
established.
G. Private Contracts and Opt-out Provision
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The changes discussed in section II.I. of this proposed
rule, with respect to private contracts and the opt-out
provision, are currently estimated to have no significant
impact on Medicare expenditures. However, we believe the
changes will clarify that the consequences for the failure
to maintain opt-out will apply regardless of whether the
physician or practitioner was notified by the carrier.
H. FQHC Supplemental Payment Provision
Section 237 of the MMA amended section 1833(a)(3) of
Act to provide supplemental payments to FQHCs that contract
with Medicare Advantage (MA) organizations to cover the
difference, if any, between the payment received by the
health center for treating MA enrollees and the payment to
which the FQHC would be entitled to receive under its
cost-based all-inclusive payment rate. We estimate that
this new MMA payment provision for FQHC services will not
increase Medicare payments. In other words, this MMA
provision would have no budgetary impact on the Medicare
trust fund due to the fact that a supplemental payment would
only be made when the MA payment to the health center is
less than its original FQHC cost based rate. Consequently,
no additional Medicare expenditures would be needed to pay