Opinion ID: 511795
Heading Depth: 2
Heading Rank: 2

Heading: Actual Charge Calculation

Text: 10 The calculation of a MAAC depends in part on a doctor's actual charge for a procedure during the 1984 base period. Section 9331 provides that the actual charge for this purpose shall be the weighted average (or, at the option of the Secretary ..., the median) of his charges for the service during the base period. OBRA Sec. 9331(b) (codified at 42 U.S.C. Sec. 1395u(j)(1)(C)(vi)). HHS chose the median method of calculating actual charges because it was the easier method for carriers to compute. No APA notice and comment procedures were used to make this choice. However, HHS noted that the median was chosen for operational rather than policy reasons and that it would be inappropriate to disadvantage any physician who is adversely affected by the selection and who wishes to charge in accordance with a self-calculated MAAC based on a weighted average of the base quarter charges. 52 Fed.Reg. 1383, 1384. The notice provides further that no sanction action will be initiated against a physician if it is determined that the physician would have been in compliance had the weighted average been used. Id.