Page:United States Statutes at Large Volume 124.djvu/460

 124 STAT. 434 PUBLIC LAW 111–148—MAR. 23, 2010 SEC. 3134. MISVALUED CODES UNDER THE PHYSICIAN FEE SCHEDULE. (a) IN GENERAL.—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 subparagraphs: ‘‘(K) POTENTIALLY MISVALUED CODES.— ‘‘(i) IN GENERAL.—The Secretary shall— ‘‘(I) periodically identify services as being potentially misvalued using criteria specified in clause (ii); and ‘‘(II) review and make appropriate adjustments to the relative values established under this para- graph for services identified as being potentially misvalued under subclause (I). ‘‘(ii) IDENTIFICATION OF POTENTIALLY MISVALUED CODES.—For purposes of identifying potentially misvalued services pursuant to clause (i)(I), the Sec- retary shall examine (as the Secretary determines to be appropriate) codes (and families of codes as appro- priate) for which there has been the fastest growth; codes (and families of codes as appropriate) that have experienced substantial changes in practice expenses; codes for new technologies or services within an appro- priate period (such as 3 years) after the relative values are initially established for such codes; multiple codes that are frequently billed in conjunction with fur- nishing a single service; codes with low relative values, particularly those that are often billed multiple times for a single treatment; codes which have not been subject to review since the implementation of the RBRVS (the so-called ‘Harvard-valued codes’); and such other codes determined to be appropriate by the Sec- retary. ‘‘(iii) REVIEW AND ADJUSTMENTS.— ‘‘(I) The Secretary may use existing processes to receive recommendations on the review and appropriate adjustment of potentially misvalued services described in clause (i)(II). ‘‘(II) The Secretary may conduct surveys, other data collection activities, studies, or other analyses as the Secretary determines to be appropriate to facilitate the review and appropriate adjustment described in clause (i)(II). ‘‘(III) The Secretary may use analytic contrac- tors to identify and analyze services identified under clause (i)(I), conduct surveys or collect data, and make recommendations on the review and appropriate adjustment of services described in clause (i)(II). ‘‘(IV) The Secretary may coordinate the review and appropriate adjustment described in clause (i)(II) with the periodic review described in subparagraph (B). ‘‘(V) As part of the review and adjustment described in clause (i)(II), including with respect to codes with low relative values described in clause (ii), the Secretary may make appropriate coding revisions (including using existing processes