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<REGINFO_RIN_DATA xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" RUN_DATE="2026-09-22-04:00" xsi:noNamespaceSchemaLocation="https://www.reginfo.gov/public/xml/REGINFO_XML_Ver10262011.xsd">
    <RIN_INFO>
        <RIN>0938-AL96</RIN>
        <PUBLICATION>
            <PUBLICATION_ID>200304</PUBLICATION_ID>
            <PUBLICATION_TITLE>Unified Agenda of Federal Regulatory and Deregulatory Actions</PUBLICATION_TITLE>
        </PUBLICATION>
        <AGENCY>
            <CODE>0938</CODE>
            <NAME>Centers for Medicare &amp; Medicaid Services</NAME>
            <ACRONYM>CMS</ACRONYM>
        </AGENCY>
        <PARENT_AGENCY>
            <CODE>0900</CODE>
            <NAME>Department of Health and Human Services</NAME>
            <ACRONYM>HHS</ACRONYM>
        </PARENT_AGENCY>
        <RULE_TITLE>Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2004 (CMS-1476-P)</RULE_TITLE>
        <ABSTRACT><![CDATA[This rule would make several changes affecting Medicare part B payment.]]></ABSTRACT>
        <PRIORITY_CATEGORY>Other Significant</PRIORITY_CATEGORY>
        <RIN_STATUS>Previously Published in The Unified Agenda</RIN_STATUS>
        <RULE_STAGE>Proposed Rule Stage</RULE_STAGE>
        <MAJOR>Yes</MAJOR>
        <UNFUNDED_MANDATE_LIST>
            <UNFUNDED_MANDATE>No</UNFUNDED_MANDATE>
        </UNFUNDED_MANDATE_LIST>
        <CFR_LIST>
            <CFR>42 CFR 410</CFR>
            <CFR>42 CFR 414</CFR>
        </CFR_LIST>
        <LEGAL_AUTHORITY_LIST>
            <LEGAL_AUTHORITY>42 USC 1395W-4</LEGAL_AUTHORITY>
        </LEGAL_AUTHORITY_LIST>
        <LEGAL_DLINE_LIST/>
        <RPLAN_ENTRY>Yes</RPLAN_ENTRY>
        <RPLAN_INFO>
            <STMT_OF_NEED><![CDATA[Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), "Payment for Physicians' Services." This section provides for three major elements: 1) a fee schedule for the payment of physicians' services; 2) a sustainable growth rate for the rates of increase in Medicare expenditures for physicians' services; and 3) limits on the amounts that nonparticipating physicians can charge beneficiaries. The Act requires that payments under the fee schedule be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense, and malpractice expense.]]></STMT_OF_NEED>
            <LEGAL_BASIS><![CDATA[Section 6102 of the Omnibus Reconciliation Act of 1989 (Pub. L. 101-239) amended the Act by adding section 1848, "Payment for Physicians' Services," which requires Medicare to pay for physicians' services under a fee schedule. Section 4644 of the Balanced Budget Act of 1997 (Pub. L. 105-33) amended section 1848(b)(1) of the Act by requiring that we publish fee schedules that establish payment amount of all physicians' services before November 1 of the preceding year, each year.]]></LEGAL_BASIS>
            <ALTERNATIVES><![CDATA[None.]]></ALTERNATIVES>
            <COSTS_AND_BENEFITS><![CDATA[The statute requires that annual adjustments to physician fee schedule RVUs not cause annual payments to differ by more than $20 million from what they would have been had the adjustments not been made. If this threshold is exceeded, we would make adjustments to the conversion factor (the dollar amount that converts relative values into a payment amount for a physician's service) to preserve budget neutrality. Because changes to RVUs must be budget neutral, if we increase a service's RVUs, we must reduce the overall multiplier (or the actual RVUs) that converts the RVUs to a dollar amount.]]></COSTS_AND_BENEFITS>
            <RISKS><![CDATA[Failure to establish payment amounts for physicians' services would place us in violation of section 1848 of the Act.]]></RISKS>
        </RPLAN_INFO>
        <TIMETABLE_LIST>
            <TIMETABLE>
                <TTBL_ACTION>NPRM</TTBL_ACTION>
                <TTBL_DATE>06/00/2003</TTBL_DATE>
            </TIMETABLE>
        </TIMETABLE_LIST>
        <RFA_REQUIRED>Yes</RFA_REQUIRED>
        <SMALL_ENTITY_LIST>
            <SMALL_ENTITY>Businesses</SMALL_ENTITY>
        </SMALL_ENTITY_LIST>
        <GOVT_LEVEL_LIST>
            <GOVT_LEVEL>Federal</GOVT_LEVEL>
        </GOVT_LEVEL_LIST>
        <FEDERALISM>No</FEDERALISM>
        <ENERGY_AFFECTED>No</ENERGY_AFFECTED>
        <PRINT_PAPER>NA</PRINT_PAPER>
        <INTERNATIONAL_INTEREST>Not Collected</INTERNATIONAL_INTEREST>
        <AGENCY_CONTACT_LIST>
            <CONTACT>
                <FIRST_NAME>Latesha</FIRST_NAME>
                <LAST_NAME>Walker</LAST_NAME>
                <TITLE>Health Insurance Specialist</TITLE>
                <AGENCY>
                    <CODE>0938</CODE>
                    <NAME>Centers for Medicare &amp; Medicaid Services</NAME>
                    <ACRONYM>CMS</ACRONYM>
                </AGENCY>
                <PHONE>410 786-1101</PHONE>
                <MAILING_ADDRESS>
                    <STREET_ADDRESS>Center for Medicare Management, 7500 Security Boulevard,</STREET_ADDRESS>
                    <CITY>Baltimore</CITY>
                    <STATE>MD</STATE>
                    <ZIP>21244</ZIP>
                </MAILING_ADDRESS>
            </CONTACT>
        </AGENCY_CONTACT_LIST>
    </RIN_INFO>
</REGINFO_RIN_DATA>
