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 pay-
ment rates. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 30, 2010 
Mr. GONZALEZ introduced the following bill; which was referred to the Com-
mittee 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 physi-
cian practice time to adjust to new payment rates. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. 4-YEAR TRANSITION IN REDUCTION IN REL-
ATIVE VALUE UNITS FOR CODES FOR CER-
TAIN 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
REDUC-
TIONS 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 pro-
vide for a 4-year transition consistent with 
clause (iii). 
‘‘(ii) APPLICABLE CODES (FOR SERV-
ICES).—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 tran-
sition under clause (i) shall apply to the 
number of percentage points of the reduc-
tion in excess of 10 percent.’’. 
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(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graphs (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 de-
scribed in clause (ii) of such subparagraph first ap-
plied 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. 
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(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 fur-
nished during 2013 in a manner as if the tran-
sition 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 rel-
ative 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. 
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(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 fur-
nished during 2013 in a manner as if the tran-
sition period began in 2011. 
(4) APPLICATION OF BUDGET NEUTRALITY.— 
Nothing in this subsection shall be construed as 
waiving the application of the budget-neutrality re-
quirement of section 1848(c)(2)(B)(ii) of the Social 
Security Act (42 U.S.C. 1395(c)(2)(B)(ii)) that oth-
erwise applies, including for the period during 2011 
beginning on April 1, 2011. 
Æ 
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