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CMS-1403-FC
For CY 2009, we proposed no update to the per
treatment drug add-on amount of $20.33 established in
CY 2008.
3. Update to the Drug Add-On Adjustment
In the CY 2009 PFS proposed rule (73 FR 38529), we
estimated a 1 percent reduction in per patient utilization
of ESRD drugs for CY 2009. Using the projected decline of
the CY 2009 ASP pricing for ESRD drugs of 1.9 percent, we
projected that the combined growth in per patient
utilization and pricing for CY 2009 would result in a
negative update equal to -2.9 percent (0.99 * 0.981 =
0.971). However, we proposed to apply a zero percent
update to the drug add-on adjustment and maintain the
$20.33 per treatment drug add-on amount for CY 2009 that
reflects a 15.5 percent drug add-on adjustment to the
composite rate for CY 2009.
In addition, for CY 2009 we presented an alternative
approach to the zero percent update. The alternative
approach would be to apply an adjustment of less than 1.0
to the drug add-on adjustment. For CY 2009, we would
“increase” the drug add-on by 0.971. Applying the 0.971
increase to the $20.33 per treatment adjustment would yield
a drug add-on amount of $19.74 per treatment, which
represents a 0.4 percent decrease in the CY 2008 drug
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