Page:United States Statutes at Large Volume 111 Part 1.djvu/460

 Ill STAT. 436 PUBLIC LAW 105-33 —AUG. 5, 1997 Services shall develop new resource-based relative value units. In developing such units the Secretary shall— (A) utilize, to the maximum extent practicable, generally accepted cost accounting principles which (i) recognize all staff, equipment, supplies, and expenses, not just those which can be tied to specific procedures, and (ii) use actual data on equipment utilization and other key assumptions; (B) consult with organizations representing physicians regarding methodology and data to be used; and (C) develop a refinement process to be used during each of the 4 years of the transition period. (2) REPORT. — The Secretary shall transmit a report by March 1, 1998, on the development of resource-based relative value units under paragraph (1) to the Committee on Ways and Means and the Committee on Commerce of the House of Representatives and the Committee on Finance of the Senate. The report shall include a presentation of data to be used in developing the value units and an explanation of the methodology. Publication. (3) NOTICE OF PROPOSED RULEMAKING. —The Secretary shall publish a notice of proposed rulemaking with the new resourcebased relative value units on or before May 1, 1998, and shall allow for a 90-day public comment period. (4) ITEMS INCLUDED.— The new proposed rule shall consider the following: (A) Impact projections which compare new proposed payment amounts on data on actual physician practice expenses. (B) Impact projections for hospital-based and other specialties, geographic payment localities, and urban versus rural localities. (e) ADJUSTMENTS TO RELATIVE VALUE UNITS FOR 1998. —Section 1848(c)(2) (42 U.S.C. 1395w-4(c)(2)) is amended by adding at the end the following new subparagraph: "(G) ADJUSTMENTS IN RELATIVE VALUE UNITS FOR 1998.— "(i) IN GENERAL.—The Secretary shall— "(I) subject to clauses (iv) and (v), reduce the practice expense relative value units applied to any services described in clause (ii) furnished in 1998 to a number equal to 110 percent of the number of work relative value units, and "(II) increase the practice expense relative value units for office visit procedure codes during 1998 by a uniform percentage which the Secretary estimates will result in an aggregate increase in pa3nnents for such services equal to the aggregate decrease in payments by reason of subclause (I). "(ii) SERVICES COVERED.— For purposes of clause (i), the services described in this clause are physicians' services that are not described in clause (iii) and for which— "(I) there are work relative value units, and

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