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HHS/CMS RIN: 0938-AI52 Publication ID: Spring 1998 
Title: ●Resource Based Practice Expense Payments and Revisions to Payment Policies for CY 1999 (HCFA-1006-P) 
Abstract: This proposed rule would make several policy changes affecting Medicare part B payment. The changes relate to physician services, including resource-based practice expense relative value units, medical direction and medical supervision rules for anesthesiologists, payment for Pap smears and for outpatient rehabilitation services, and payment based on actual charges. Under the law, we are required to develop a resource-based system for determining practice expense relative value units. The Balance Budged Act of 1997 (BBA 1997) delayed, for 1 year, implementation of the resource-based practice expense relative value units until January 1, 1999. Under BBA 1997, we are required to revise our payment policy for nonphysician practitioners for drugs and biologicals not paid on a cost or prospective payment basis. In addition, BBA 1997 permits certain physicians and practitioners to opt out of Medicare and furnish covered serviced to medicare beneficiaries through private contracts. Also, we would rebase the Medicare Economic Index from a 1989 base year to a 1996 base year. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 405    42 CFR 410    42 CFR 414 to 415   
Legal Authority: 42 USC 1395-W-4   
Legal Deadline:
Action Source Description Date
NPRM  Statutory    05/01/1998 
Timetable:
Action Date FR Cite
Final Action  05/00/1998    
Final Action Effective  01/00/1999    
Additional Information: Legal Authority: PL-105-33, sec 4505 PL-105-33, sec 4505 PL-105-33, sec 4507 PL-105-33, sec 4511 PL-105-33, sec 4512 PL-105-33, sec 4541 PL-105-33, sec 4556
Regulatory Flexibility Analysis Required: Yes  Government Levels Affected: None 
Small Entities Affected: Businesses 
Included in the Regulatory Plan: No 
Agency Contact:
Stanley Weintraub
Center for Health Plans and Providers
Department of Health and Human Services
Centers for Medicare & Medicaid Services
7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-4498