Text: H.R.6459 — 111th Congress (2009-2010)

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Introduced in House (11/30/2010)


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[Congressional Bills 111th Congress]
[From the U.S. Government Printing Office]
[H.R. 6459 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 6459

  To amend section 1848 of the Social Security Act to provide for a 4-
year transition in reductions in relative value units for certain newly 
  bundled services to allow physician practice time to adjust to new 
                             payment rates.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 30, 2010

 Mr. Gonzalez introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To amend section 1848 of the Social Security Act to provide for a 4-
year transition in reductions in relative value units for certain newly 
  bundled services to allow physician practice time to adjust to new 
                             payment rates.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. 4-YEAR TRANSITION IN REDUCTION IN RELATIVE VALUE UNITS FOR 
              CODES FOR CERTAIN SERVICES.

    (a) In General.--Section 1848(c)(2) of the Social Security Act (42 
U.S.C. 1395w-4(c)(2)) is amended by adding at the end the following new 
subparagraph:
                    ``(M) 4-year transition for reductions in relative 
                value units for codes for certain services.--
                            ``(i) In general.--In the case of codes 
                        (for services) described in clause (ii) for 
                        which a change in relative value units results 
                        in a reduction in such units of 10 percent or 
                        more, the Secretary shall provide for a 4-year 
                        transition consistent with clause (iii).
                            ``(ii) Applicable codes (for services).--
                        For purposes of clause (i), the codes (for 
                        services) described in this clause are codes 
                        (for services) for which a single code is used 
                        for payment for services for which multiple 
                        codes were previously used.
                            ``(iii) Transition.--The 4-year transition 
                        under clause (i) shall apply to the number of 
                        percentage points of the reduction in excess of 
                        10 percent.''.
    (b) Effective Date.--
            (1) In general.--Except as provided in paragraphs (2) and 
        (3), subparagraph (M) of section 1848(c)(2) of the Social 
        Security Act, as added by the amendment made by subsection (a), 
        shall apply to relative value units for codes applicable to 
        services furnished on or after January 1, 2012.
            (2) Exception for new codes in 2010.--In the case of 
        relative value units for which codes described in clause (ii) 
        of such subparagraph first applied to services furnished on or 
        after January 1, 2010, the following rules shall apply:
                    (A) 2011.--Such subparagraph shall apply to such 
                codes for services furnished during 2011 (on or after 
                April 1, 2011) and the second year of a 4-year 
                transition shall be applied to relative value units for 
                codes for such services in a manner as if the 
                transition period began in 2010.
                    (B) 2012.--In applying such subparagraph to 
                services furnished during 2012, the third year of a 4-
                year transition shall be applied to relative value 
                units for codes for such services in a manner as if the 
                transition period began in 2010.
                    (C) 2013.--In applying such subparagraph to 
                services furnished during 2013, the fourth year of a 4-
                year transition shall be applied to relative value 
                units for codes for services furnished during 2013 in a 
                manner as if the transition period began in 2010.
            (3) Exception for new codes after 2011.--In the case of 
        relative value units for codes described in clause (ii) of such 
        subparagraph first applied to services furnished on or after 
        January 1, 2011, the following rules shall apply with respect 
        to such amendment:
                    (A) 2011.--Such subparagraph shall apply to such 
                codes for services furnished during 2011 (on or after 
                April 1, 2011) and first year of a 4-year transition 
                shall be applied to relative value units for codes for 
                such services in a manner as if the transition period 
                began in 2011.
                    (B) 2012.--In applying such subparagraph to 
                services furnished during 2012, the second year of a 4-
                year transition shall be applied to relative value 
                units for codes for such services in a manner as if the 
                transition period began in 2011.
                    (C) 2013.--In applying such subparagraph to 
                services furnished during 2013, the third year of a 4-
                year transition shall be applied to relative value 
                units for codes for services furnished during 2013 in a 
                manner as if the transition period began in 2011.
            (4) Application of budget neutrality.--Nothing in this 
        subsection shall be construed as waiving the application of the 
        budget-neutrality requirement of section 1848(c)(2)(B)(ii) of 
        the Social Security Act (42 U.S.C. 1395(c)(2)(B)(ii)) that 
        otherwise applies, including for the period during 2011 
        beginning on April 1, 2011.
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