05.02.2013 Views

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for ...

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for ...

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for ...

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

CMS-1503-FC 356<br />

services under the PFS.<br />

Comment: Of the many commenters who supported CMS' proposal to adjust the<br />

RVU shares to match the proportions <strong>for</strong> work, PE, and malpractice in the rebased<br />

CY 2011 MEI, the vast majority also favored adjusting the RVU shares upward <strong>for</strong> PE<br />

and malpractice while making a corresponding adjustment to the conversion factor <strong>for</strong><br />

budget neutrality without modifying the RVUs <strong>for</strong> work. These commenters stated that<br />

stability in the work RVUs was desirable. However, some commenters also expressed<br />

concern that CMS proposed an additional downward adjustment to the conversion factor<br />

when, under current law, the effect of the SGR update <strong>for</strong>mula in December of 2010 and<br />

CY 2011 would reduce PFS payments significantly. These commenters generally<br />

opposed the MEI rebasing and the adjustment to the RVUs to match the MEI weights;<br />

however, if CMS were to proceed with the policy, the commenters suggested that, at the<br />

very least the adjustments be phased in over 2 or 4 years. A few commenters suggested<br />

replacing the SGR update <strong>for</strong>mula entirely with the MEI.<br />

Response: We are sympathetic to the commenters' concern that an additional<br />

downward adjustment to the conversion factor on top of the negative effect of the<br />

statutory SGR-based update is inopportune. However, as we explained in the proposed<br />

rule (75 FR 40095) and discussed previously in this section, rather than applying<br />

adjustments directly to the work, PE, and malpractice RVUs in order to match the<br />

rebased MEI weights <strong>for</strong> those categories, we believe that it is appropriate <strong>for</strong> the work<br />

RVUs to remain stable over time. The only way we can make the adjustments without<br />

affecting the work RVUs is to also make an adjustment to the conversion factor. We note<br />

that we did not receive a public comment suggesting that we make the downward

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!