I 

113TH CONGRESS 

1ST SESSION H. R. 2545 

To amend title XVIII of the Social Security Act to provide for an expert 

advisory panel regarding relative value scale process used under the 

Medicare physician fee schedule, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 27, 2013 

Mr. MCDERMOTT 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 title XVIII of the Social Security Act to provide 

for an expert advisory panel regarding relative value 

scale process used under the Medicare physician fee 

schedule, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Accuracy in Medicare 

5 Physician Payment Act of 2013’’. 


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1 SEC. 2. EXPERT ADVISORY PANEL REGARDING RELATIVE 

2 VALUE SCALE PROCESS USED IN MEDICARE 

3 PHYSICIAN FEE SCHEDULE. 

4 Section 1848(c)(2) of the Social Security Act (42 

5 U.S.C. 1395m(c)(2)) is amended by adding at the end the 

6 following new subparagraph: 

7 ‘‘(M) USE OF EXPERT ADVISORY PANEL

8 REGARDING RELATIVE VALUE SCALE PROCESS

9 USED.— 

10 ‘‘(i) IN GENERAL.—For purposes of 

11 providing oversight to the processes (in12 cluding the process described in subpara13 graph (K)) relating to valuation of physi14 cians’ services, not later than 90 days after 

15 the date of the enactment of this subpara16 graph, the Secretary shall establish and 

17 appoint an expert outside advisory panel 

18 (in this subparagraph referred to as the 

19 ‘panel’). 

20 ‘‘(ii) COMPOSITION OF PANEL.—The 

21 panel shall be composed of individuals with 

22 expertise in the valuation of physicians’ 

23 services, such as individuals who are med24 ical directors for carriers, experts in med25 ical economics and technology diffusion, 

26 and private payer plan representatives, and 


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1 shall include a mix of physicians in dif2 ferent specialty areas, particularly physi3 cians who are not directly affected by 

4 changes in the valuation of physicians’ 

5 services under this section (such as retired 

6 physicians and physicians who are em7 ployed by managed care organizations or 

8 academic medical centers), as well as rep9 resentatives of individuals enrolled under 

10 this part. 

11 ‘‘(iii) DUTIES.— 

12 ‘‘(I) IN GENERAL.—The panel 

13 shall provide oversight to the proc14 esses of identifying, reviewing, and 

15 adjusting valuations for physicians’ 

16 services under this section, including 

17 activities described in the succeeding 

18 provisions of this clause. 

19 ‘‘(II) ESTABLISHMENT OF

20 SCREENS.—The panel may establish 

21 screens (in addition to the screens 

22 identified under subparagraph (K)(ii)) 

23 and other means for identifying physi24 cians’ services for which there are po25 tentially misvalued codes for review, 


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1 such as services that have experienced 

2 substantial changes in length of stay, 

3 site of service, volume, practice ex4 pense, and other factors that may in5 dicate changes in physician work. 

6 ‘‘(III) DATA COLLECTION.—The 

7 panel may collect data and develop 

8 supporting evidence relating to the 

9 valuation of physicians’ services. 

10 ‘‘(IV) SURVEYS.—The panel may 

11 conduct surveys of suppliers of physi12 cians’ services and may conduct time 

13 and motion studies relating to such 

14 valuations. 

15 ‘‘(V) TRANSMITTING CODES FOR

16 REVIEW AND RECOMMENDATIONS.— 

17 The panel may transmit with sup18 porting evidence codes for review and 

19 recommendations through the means 

20 described in subparagraphs (I) 

21 through (III) of subparagraph 

22 (K)(iii). 

23 ‘‘(VI) EVALUATION OF REC24 OMMENDATIONS SUBMITTED.—The 

25 panel shall evaluate any recommendaVerDate Mar 15 2010 04:31 Jul 03, 2013 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2545.IH H2545

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1 tions submitted through such means 

2 (whether pursuant to the solicitation 

3 under subclause (V) or otherwise) and 

4 report to the Secretary on such eval5 uation. 

6 The panel’s activities under subclauses 

7 (III) and (IV) may be conducted directly 

8 or through contracts with appropriate, 

9 qualified entities. 

10 ‘‘(iv) APPLICATION OF FACA.—The 

11 Federal Advisory Committee Act (5 U.S.C. 

12 App.) shall apply to the panel, except that 

13 section 14 of such Act shall not apply. 

14 ‘‘(v) FUNDING.—The Secretary shall 

15 provide for the transfer of not to exceed 

16 $10,000,000 for each fiscal year (begin17 ning with fiscal year 2014) from the Fed18 eral Medical Supplementary Medical Insur19 ance Trust Fund established in section 

20 1841 to the Center for Medicare & Med21 icaid Services Program Management Ac22 count to carry out this subparagraph, in23 cluding for the management and staffing 


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1 of the panel and the conduct of activities 

2 described in clause (iii).’’. 

Æ 


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