Page:United States Statutes at Large Volume 100 Part 1.djvu/227

 PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 191

the 'Director' and the 'Office', respectively) shall provide for the appointment of a Physician Payment Review Commission (hereinafter in this section referred to as the 'Commission'), to be composed of individuals with expertise in the provision and financing of physicians' services appointed by the Director (without regard to the provisions of title 5, United States Code, governing appointments in the competitive service). "(2) The Commission shall consist of 11 individuals. Members of the Commission shall first be appointed no later than May 1, 1986, for a term of three years, except that the Director may provide initially for such shorter terms as will insure that (on a continuing basis) the terms of no more than four members expire in any one year. "(3) The membership of the Commission shall include physicians, other health professionals, individuals skilled in the conduct and interpretation of biomedical, health services, and health economics research, and representatives of consumers and the elderly. The Director shall seek nominations from a wide range of groups, including— "(A) national organizations representing physicians, including medical specialty organizations, "(B) organizations representing the elderly and consumers, "(C) national organizations representing medical schools, "(D) national organizations representing hospitals, including teaching hospitals, and "(E) national organizations representing health benefits programs. "(b)(1) The Commission shall make recommendations to the Congress, not later than March 1 of each year (beginning with 1987), regarding adjustments to the reasonable charge levels for physicians' services recognized under section 1842(b) and changes in the methodology for determining the rates of payment, and for making payment, for physicians' services under this title and other items and services under this part. "(2) In making its recommendations, the Commission shall— "(A) consider, and make recommendations on the feasibility and desirability of reducing, the differences in payment amounts for physicians' services under this part which are based on differences in geographic location or specialty; "(B) review the input costs (including time, professional skills, and risks) associated with the provision of different physicians' services; "(C) identify those charges recognized as reasonable under section 1842(b) which are significantly out-of-line, based on the 42 USC I395u. considerations of subparagraphs (A) and (B); "(D) assess the likely impact of different adjustments in pay ment rates, particularly their impact on physician participation in the participation program established under section 1842(h) and on beneficiary access to necessary physicians' services; "(E) make recommendations on ways to increase physician participation in that participation program and the acceptance of payment under this part on an assignment-related basis; "(F) make recommendations respecting the advisability and feasibility of making changes in the payment system for physicians' services under this part based on (i) the Secretary's study under section 603(b)(2) of the Social Security Amendments of 1983 (relating to payments for physicians' services furnished to 42 USC I395b-l note.

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