[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4371 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 4371

To amend title XVIII of the Social Security Act to continue using 2009 
 Medicare practice expense relative value units for certain cardiology 
                               services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 16, 2009

  Mr. Gonzalez (for himself, Mr. Ortiz, Mr. Boren, Mr. Griffith, Mr. 
   Thornberry, Mr. Meek of Florida, Mr. Courtney, Mr. Garrett of New 
Jersey, Mr. Arcuri, Mr. Carnahan, Mr. Hall of Texas, Mr. Ruppersberger, 
 Mr. Moran of Virginia, Mr. Scott of Georgia, Mr. Akin, Mr. Pitts, Mr. 
  Cuellar, Mr. Kagen, Mr. McIntyre, Mr. Grayson, Mrs. McCarthy of New 
York, Mr. Bishop of Georgia, Mr. Cummings, Mr. Massa, Mr. Bartlett, Mr. 
 Cohen, Mr. Peters, Mr. Berry, Mr. Himes, Ms. McCollum, Mr. Bishop of 
  New York, Mrs. Lowey, Mr. Maffei, Mr. Clay, Mr. Murphy of New York, 
Mrs. Christensen, Mr. Kratovil, Mr. Roe of Tennessee, Mr. Wittman, Mr. 
 Butterfield, Mr. Israel, Mr. Luetkemeyer, Mr. Rush, Mr. Marchant, Mr. 
 Hill, Ms. Wasserman Schultz, Mr. Lincoln Diaz-Balart of Florida, Ms. 
  Norton, Mr. LoBiondo, Ms. Kosmas, Mr. Dent, Mr. Faleomavaega, Mrs. 
Biggert, Mr. Adler of New Jersey, Mr. Gerlach, and Mr. Paul) 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 title XVIII of the Social Security Act to continue using 2009 
 Medicare practice expense relative value units for certain cardiology 
                               services.

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

SECTION 1. CONTINUED USE OF 2009 MEDICARE PRACTICE EXPENSE RELATIVE 
              VALUE UNITS FOR CERTAIN CARDIOLOGY SERVICES.

    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:
                    ``(K) Continued use of 2009 practice expense 
                relative value units for certain cardiology services.--
                            ``(i) In general.--Notwithstanding any 
                        other provision of law, including provisions 
                        contained in the final rule published in the 
                        Federal Register on November 25, 2009 (74 Fed. 
                        Reg. 61737), relating to CY 2010 relative value 
                        units, subject to clause (iii) and the second 
                        sentence of clause (iv), in determining the 
                        practice expense payment under this paragraph 
                        for services performed predominantly by 
                        cardiologists and furnished on or after January 
                        1, 2010, the Secretary shall continue practice 
                        expense relative value units at the levels for 
                        CY 2009 for such services. For purposes of the 
                        previous sentence, the services performed 
                        predominantly by cardiologists include (as 
                        determined by the Secretary) cardiac monitoring 
                        services, services performed primarily for the 
                        diagnosis or treatment of heart disease, and 
                        other services at least 50 percent of which are 
                        performed under this part by cardiologists.
                            ``(ii) Inclusion of specific cardiac 
                        codes.--In determining practice expense 
                        relative value units under this paragraph for 
                        myocardial perfusion imaging (CPT codes 78451-
                        78454) for services furnished on or after 
                        January 1, 2010, subject to clause (iii) and 
                        the second sentence of clause (iv), the 
                        Secretary shall use the 2009 practice expense 
                        relative value units for the previous codes 
                        that were combined to create such CPT codes.
                            ``(iii) New cpt code implementation 
                        permitted.--Nothing in clause (i) or (ii) shall 
                        be construed to prevent new category I CPT 
                        codes related to cardiovascular computed 
                        tomography and cardiovascular magnetic 
                        resonance imaging, published in the rule 
                        referred to in clause (i), from taking effect 
                        on January 1, 2010.
                            ``(iv) Study and report on practice expense 
                        methodology.--The Secretary, in consultation 
                        with medical specialty society stakeholders and 
                        other affected stakeholders, shall enter into a 
                        contract with an independent entity--
                                    ``(I) to conduct a study of the 
                                practice expense methodology used to 
                                determine relative value units under 
                                this paragraph to determine whether the 
                                cost finding, indirect cost allocation, 
                                scaling, and budget neutrality 
                                methodologies used are consistent with 
                                generally accepted accounting 
                                principles, distribute the burden of 
                                any necessary budget neutrality 
                                adjustments proportionally among all 
                                physicians' services, comparison to 
                                other payment methodologies, and result 
                                in allowances that accurately reflect 
                                the relative direct and indirect 
                                resources involved in the provision of 
                                various physicians' services; and
                                    ``(II) to submit to the Secretary 
                                and Congress no later than January 1, 
                                2011, a report on such study that 
                                includes recommendations for 
                                determining practice expense under this 
                                subsection.
                        Upon completion of such study, the Secretary 
                        may adjust the practice expense relative value 
                        units described in clause (i) and the codes 
                        described in clause (ii) for services furnished 
                        on or after such date (not earlier than January 
                        1, 2012) as the Secretary may specify.
                            ``(v) No budget neutrality adjustment.--The 
                        Secretary shall not make any reduction in 
                        relative value units or other budget neutrality 
                        adjustments pursuant to the application of the 
                        previous provisions of this subparagraph.''.
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