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
362 For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services proposes to amend 42 CFR chapter IV as set forth below: PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED 1. The authority citation for part 405 continues to read as follows: Authority: Secs. 1102, 1861, 1862(a), 1871, 1874, 1881, and 1886(k) of the Social Security Act (42 U.S.C. 1302, 1395x, 1395y(a), 1395hh, 1395kk, 1395rr, and 1395ww(k)), and sec. 353 of the Public Health Service Act (42 U.S.C. 263a). Subpart D--Private Contracts 2. Section 405.435 is amended by-- A. Revising introductory text in paragraph (b). B. Adding paragraph (d). The revision and addition read as follows: §405.435 Failure to maintain opt-out. * * * * * (b) If a physician or practitioner fails to maintain opt-out in accordance with paragraph (a) of this section, then, for the remainder of the opt-out period, except as provided by paragraph (d) of this section-- * * * * * (d) If a physician or practitioner demonstrates that he or she has taken good faith efforts to maintain opt-out
(including by refunding amounts in excess of the charge 363 limits to beneficiaries with whom he or she did not sign a private contract) within 45 days of a notice from the carrier of a violation of paragraph (a) of this section, then the requirements of paragraphs (b)(1) through (b)(8) of this section are not applicable. In situations where a violation of paragraph (a) of this section is not discovered by the carrier during the 2-year opt-out period when the violation actually occurred, then the requirements of paragraphs (b)(1) through (b)(8) of this section are applicable from the date that the first violation of paragraph (a) of this section occurred until the end of the opt-out period during which the violation occurred (unless the physician or practitioner takes good faith efforts, within 45 days of any notice from the carrier that the physician or practitioner failed to maintain opt-out, or the physician’s or practitioner’s discovery of the failure to maintain opt-out, whichever is earlier, to correct his or her violations of paragraph (a) of this section, for example, by refunding the amounts in excess of the charge limits to beneficiaries with whom he or she did not sign a private contract). * * * * * Subpart X--Rural Health Clinic and Federally Qualified Health Center Services
- 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 and 342: 341 have undertaken a similar analy
- Page 343 and 344: of the updated GPCI data. For the R
- 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: List of Subjects 42 CFR Part 405 Ad
- 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
- Page 393 and 394: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 395 and 396: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 397 and 398: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 399 and 400: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 401 and 402: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 403 and 404: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 405 and 406: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 407 and 408: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 409 and 410: ADDENDUM B: RELATIVE VALUE UNITS (R
- Page 411 and 412: ADDENDUM B: RELATIVE VALUE UNITS (R
(including by refunding amounts in excess <strong>of</strong> the charge<br />
363<br />
limits to beneficiaries with whom he or she did not sign a<br />
private contract) within 45 days <strong>of</strong> a notice from the<br />
carrier <strong>of</strong> a violation <strong>of</strong> paragraph (a) <strong>of</strong> this section,<br />
then the requirements <strong>of</strong> paragraphs (b)(1) through (b)(8) <strong>of</strong><br />
this section are not applicable. In situations where a<br />
violation <strong>of</strong> paragraph (a) <strong>of</strong> this section is not discovered<br />
by the carrier during the 2-year opt-out period when the<br />
violation actually occurred, then the requirements <strong>of</strong><br />
paragraphs (b)(1) through (b)(8) <strong>of</strong> this section are<br />
applicable from the date that the first violation <strong>of</strong><br />
paragraph (a) <strong>of</strong> this section occurred until the end <strong>of</strong> the<br />
opt-out period during which the violation occurred (unless<br />
the physician or practitioner takes good faith efforts,<br />
within 45 days <strong>of</strong> any notice from the carrier that the<br />
physician or practitioner failed to maintain opt-out, or the<br />
physician’s or practitioner’s discovery <strong>of</strong> the failure to<br />
maintain opt-out, whichever is earlier, to correct his or<br />
her violations <strong>of</strong> paragraph (a) <strong>of</strong> this section, for<br />
example, by refunding the amounts in excess <strong>of</strong> the charge<br />
limits to beneficiaries with whom he or she did not sign a<br />
private contract).<br />
* * * * *<br />
Subpart X--Rural Health Clinic and Federally Qualified<br />
Health Center Services