I 

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. 

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


pwalker on DSKD5P82C1PROD with BILLS
2 

•HR 6459 IH

1 SECTION 1. 4-YEAR TRANSITION IN REDUCTION IN REL2 ATIVE VALUE UNITS FOR CODES FOR CER3 TAIN SERVICES. 

4 (a) IN GENERAL.—Section 1848(c)(2) of the Social 

5 Security Act (42 U.S.C. 1395w–4(c)(2)) is amended by 

6 adding at the end the following new subparagraph: 

7 ‘‘(M) 4-YEAR TRANSITION FOR REDUC8 TIONS IN RELATIVE VALUE UNITS FOR CODES

9 FOR CERTAIN SERVICES.— 

10 ‘‘(i) IN GENERAL.—In the case of 

11 codes (for services) described in clause (ii) 

12 for which a change in relative value units 

13 results in a reduction in such units of 10 

14 percent or more, the Secretary shall pro15 vide for a 4-year transition consistent with 

16 clause (iii). 

17 ‘‘(ii) APPLICABLE CODES (FOR SERV18 ICES).—For purposes of clause (i), the 

19 codes (for services) described in this clause 

20 are codes (for services) for which a single 

21 code is used for payment for services for 

22 which multiple codes were previously used. 

23 ‘‘(iii) TRANSITION.—The 4-year tran24 sition under clause (i) shall apply to the 

25 number of percentage points of the reduc26 tion in excess of 10 percent.’’. 


pwalker on DSKD5P82C1PROD with BILLS
3 

•HR 6459 IH

1 (b) EFFECTIVE DATE.— 

2 (1) IN GENERAL.—Except as provided in para3 graphs (2) and (3), subparagraph (M) of section 

4 1848(c)(2) of the Social Security Act, as added by 

5 the amendment made by subsection (a), shall apply 

6 to relative value units for codes applicable to services 

7 furnished on or after January 1, 2012. 

8 (2) EXCEPTION FOR NEW CODES IN 2010.—In 

9 the case of relative value units for which codes de10 scribed in clause (ii) of such subparagraph first ap11 plied to services furnished on or after January 1, 

12 2010, the following rules shall apply: 

13 (A) 2011.—Such subparagraph shall apply 

14 to such codes for services furnished during 

15 2011 (on or after April 1, 2011) and the second 

16 year of a 4-year transition shall be applied to 

17 relative value units for codes for such services 

18 in a manner as if the transition period began 

19 in 2010. 

20 (B) 2012.—In applying such subparagraph 

21 to services furnished during 2012, the third 

22 year of a 4-year transition shall be applied to 

23 relative value units for codes for such services 

24 in a manner as if the transition period began 

25 in 2010. 


pwalker on DSKD5P82C1PROD with BILLS
4 

•HR 6459 IH

1 (C) 2013.—In applying such subparagraph 

2 to services furnished during 2013, the fourth 

3 year of a 4-year transition shall be applied to 

4 relative value units for codes for services fur5 nished during 2013 in a manner as if the tran6 sition period began in 2010. 

7 (3) EXCEPTION FOR NEW CODES AFTER 2011.— 

8 In the case of relative value units for codes described 

9 in clause (ii) of such subparagraph first applied to 

10 services furnished on or after January 1, 2011, the 

11 following rules shall apply with respect to such 

12 amendment: 

13 (A) 2011.—Such subparagraph shall apply 

14 to such codes for services furnished during 

15 2011 (on or after April 1, 2011) and first year 

16 of a 4-year transition shall be applied to rel17 ative value units for codes for such services in 

18 a manner as if the transition period began in 

19 2011. 

20 (B) 2012.—In applying such subparagraph 

21 to services furnished during 2012, the second 

22 year of a 4-year transition shall be applied to 

23 relative value units for codes for such services 

24 in a manner as if the transition period began 

25 in 2011. 


pwalker on DSKD5P82C1PROD with BILLS
5 

•HR 6459 IH

1 (C) 2013.—In applying such subparagraph 

2 to services furnished during 2013, the third 

3 year of a 4-year transition shall be applied to 

4 relative value units for codes for services fur5 nished during 2013 in a manner as if the tran6 sition period began in 2011. 

7 (4) APPLICATION OF BUDGET NEUTRALITY.— 

8 Nothing in this subsection shall be construed as 

9 waiving the application of the budget-neutrality re10 quirement of section 1848(c)(2)(B)(ii) of the Social 

11 Security Act (42 U.S.C. 1395(c)(2)(B)(ii)) that oth12 erwise applies, including for the period during 2011 

13 beginning on April 1, 2011. 

Æ 


pwalker on DSKD5P82C1PROD with BILLS