,i  #aaith ,,congress  #b;d ,session    
,h4 ,r4 #gebj  ,,in ,,the ,,house ,,of  
,,representatives  ,february #ab1       
#bjbf,mr4 ,estes 7for himself and ,mr4  
,suozzi7 introduced the following bill2 
which was referred to the ,committee on 
,energy and ,commerce1 and in addition  
to the ,committee on ,ways and ,means1  
for a period to be subsequently         
determined by the ,speaker1 in each case
 for consideration of such provisions as
 fall within the jurisdiction of the    
committee concerned  ,a ,,bill  ,to     
amend title ,,xviii of the ,social      
,security ,act to delay the             
implementation of an efficiency         
adjustment to work relative value units 
under the ,medicare physician fee       
schedule4  #a4 ,short title ,this ,act  
may be cited as the ,efficiency         
,adjustment ,delay ,act4  #b4 ,delaying 
the implementation of an efficiency     
adjustment to work relative value units 
under the ,medicare physician fee       
schedule  7a7 ,in general ,section      

#ahdh7;c7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #aciew-#d7;c77 is amended
 by adding at the end the following new 
paragraph3  7#i7 ,delayed implementation
 of work ,,rvu efficiency adjustment    
7,a7  ,delayed implementation  ,the     
,secretary may not implement the policy 
established in the final rule published 
on ,november #e1 #bjbe 7#ij ,fed4 ,reg4 
#dibff et seq471 that establishes an    
efficiency adjustment to work relative  
value units1 and makes corresponding    
updates to the intraservice portion of  
physician time inputs for non-time-based
 services1 before ,january #a1 #bjcj4   
7,b7 ,report to ,congress ,not later    
than #b years after the date of the     
enactment of this paragraph1 the        
,secretary shall submit to the          
,committee on ,energy and ,commerce and 
the ,committee on ,ways and ,means of   
the ,house of ,representatives1 and to  
the ,committee on ,finance of the       
,senate1 a report containing an         
assessment of whether it is necessary to

 apply a one-time1 across-the-board     
adjustment to work relative value units1
 and to make corresponding updates to   
the intraservice portion of physician   
time inputs for non-time-based services1
 with respect to services that have not 
been revalued or reviewed within the    
#aj-year period preceding the calendar  
year in which such one-time adjustment  
would be applied4 ,such report shall    
include supporting evidence for such    
assessment4  7,c7 ,limitations on future
 implementation  7i7 ,in general        
,subject to clause 7ii71 in the case    
that the report under subparagraph 7,b7 
supports the implementation of the      
efficiency adjustment described in      
subparagraph 7,a71 the ,secretary may   
implement such adjustment on or after   
,january #a1 #bjcj1 if the following    
conditions are met3  7,i7 ,before       
implementing such adjustment1 the       
,secretary consults with representatives
 of physician specialties affected by   
the potential implementation of such    

adjustment4  7,,ii7 ,the ,secretary does
 not implement such adjustment with     
respect to services that have been      
revalued or reviewed within the #aj-year
 period preceding the calendar year in  
which such one-time adjustment would be 
applied4  7,,iii7 ,the ,secretary       
establishes a methodology for           
calculating such adjustment that does   
not rely on a factor that is used for   
determining productivity relative to    
inflation unless the update to the      
nonqualifying ,,apm conversion factor   
under section #ahdh7;d7 for the year in 
which the one-time adjustment would be  
applied is greater than or equal to the 
percentage increase in the consumer     
price index for all urban consumers 7all
 items2 ,united ,states city average7   
over the previous year4  7ii7 ,multiple 
adjustments prohibited ,the ,secretary  
may not implement such an efficiency    
adjustment more than once4  7,d7 ,rule  
of construction ,nothing in subparagraph
 7,a7 shall be construed to prevent the 

,secretary from revaluing misvalued     
codes for specific services or assigning
 values to new or revised codes for     
services4  4  7b7 ,adjustment to        
conversion factor ,section              
#ahdh7;d77#bj7 of the ,social ,security 
,act 7#db ,u4,s4,c4 #aciew-#d7;d77#bj77 
is amended--  7#a7 by striking #j4ge    
percent and inserting #a4bd percent2    
7#b7 by striking #j4be percent and      
inserting #j4gd percent2  7#c7 by       
striking ,for #bjbf and each subsequent 
year and inserting the following3  7,a7 
,update for #bjbf ,for #bjbf  2 and     
7#d7 by adding at the end the following 
new subparagraph3  7,b7 ,update for     
#bjbg and subsequent years ,for #bjbg   
and each subsequent year1 the update to 
the qualifying ,,apm conversion factor  
established under paragraph 7#a77;,a7 is
 #j4ge percent1 and the update to the   
nonqualifying ,,apm conversion factor   
established under such paragraph is     
#j4be percent4  4