Medicare program; delay in implementing the adjustments to the practice expense relative value units under the...

Area of Science:

• Health Policy
• Medical Economics

Background:

• The Medicare physician fee schedule is subject to regulatory changes.
• The Balanced Budget Act of 1997 (BBA 1997) introduced significant modifications.

Purpose of the Study:

• To identify provisions in Medicare physician fee schedule regulations affected by the BBA 1997.
• To outline the implications of Section 4505 of the BBA 1997 on practice expense relative value units.

Main Methods:

• Analysis of Medicare physician fee schedule regulations.
• Interpretation of Section 4505 of the BBA 1997.

Main Results:

• Postponement of the resource-based practice expense relative value unit system implementation to January 1, 1999.
• Establishment of a 4-year transition period for the new system.
• An adjustment for practice expense relative value units for 1998 is mandated.

Conclusions:

• The BBA 1997 necessitates a revision of previously proposed rules for practice expense.
• A new proposed rule for practice expense must be published by May 1, 1998.