,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #gebj  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #ab1         
#bjbf,mr4 ,e/es 7= himself & ,mr4       
,suozzi7 introduc$ ! foll[+ bill2 :i* 0 
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
delay ! implem5tation ( an effici5cy    
adju/m5t to "w relative value units "u !
 ,m$ic>e physician fee s*$ule4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,effici5cy ,adju/m5t ,delay ,act4  #b4  
,delay+ ! implem5tation ( an effici5cy  
adju/m5t to "w relative value units "u !
 ,m$ic>e physician fee s*$ule  7a7 ,9   
g5]al ,section #ahdh7;c7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;c77 is am5d$ by add+ at ! end
 ! foll[+ new p>agraph3  7#i7 ,delay$   

implem5tation ( "w ,,rvu effici5cy      
adju/m5t  7,a7  ,delay$ implem5tation   
,! ,secret>y may n implem5t ! policy    
e/abli%$ 9 ! f9al rule publi%$ on       
,novemb] #e1 #bjbe 7#ij ,f$4 ,reg4      
#dibff et seq471 t e/abli%es an         
effici5cy adju/m5t to "w relative value 
units1 & makes correspond+ updates to ! 
intras]vice portion ( physician "t      
inputs = non-"t-bas$ s]vices1 be=e      
,janu>y #a1 #bjcj4  7,b7 ,report to     
,congress ,n lat] ?an #b ye>s aft] !    
date ( ! enactm5t ( ?is p>agraph1 !     
,secret>y %all submit to ! ,committee on
 ,en]gy & ,comm]ce & ! ,committee on    
,ways & ,means ( ! ,h\se (              
,repres5tatives1 & to ! ,committee on   
,f9ance ( ! ,s5ate1 a report conta9+ an 
assessm5t ( :e!r x is necess>y to apply 
a "o-"t1 across-!-bo>d adju/m5t to "w   
relative value units1 & to make         
correspond+ updates to ! intras]vice    
portion ( physician "t inputs =         
non-"t-bas$ s]vices1 ) respect to       
s]vices t h n be5 revalu$ or review$ )9 

! #aj-ye> p]iod prec$+ ! cal5d> ye> 9   
:i* su* "o-"t adju/m5t w\ld be appli$4  
,su* report %all include support+       
evid5ce = su* assessm5t4  7,c7          
,limitations on future implem5tation    
7i7 ,9 g5]al ,subject to clause 7ii71 9 
! case t ! report "u subp>agraph 7,b7   
supports ! implem5tation ( ! effici5cy  
adju/m5t describ$ 9 subp>agraph 7,a71 ! 
,secret>y may implem5t su* adju/m5t on  
or aft] ,janu>y #a1 #bjcj1 if ! foll[+  
conditions are met3  7,i7 ,be=e         
implem5t+ su* adju/m5t1 ! ,secret>y     
consults ) repres5tatives ( physician   
specialties affect$ by ! pot5tial       
implem5tation ( su* adju/m5t4  7,,ii7 ,!
 ,secret>y does n implem5t su* adju/m5t 
) respect to s]vices t h be5 revalu$ or 
review$ )9 ! #aj-ye> p]iod prec$+ !     
cal5d> ye> 9 :i* su* "o-"t adju/m5t w\ld
 be appli$4  7,,iii7 ,! ,secret>y       
e/abli%es a me?odology = calculat+ su*  
adju/m5t t does n rely on a factor t is 
us$ = det]m9+ productivity relative to  
inflation unless ! update to !          

nonqualify+ ,,apm conv]sion factor "u   
section #ahdh7;d7 = ! ye> 9 :i* ! "o-"t 
adju/m5t w\ld be appli$ is great] ?an or
 equal to ! p]c5tage increase 9 !       
consum] price index = all urban consum]s
 7all items2 ,unit$ ,/ates city av]age7 
ov] ! previ\s ye>4  7ii7 ,multiple      
adju/m5ts prohibit$ ,! ,secret>y may n  
implem5t su* an effici5cy adju/m5t m ?an
 once4  7,d7 ,rule ( con/ruction ,no?+ 9
 subp>agraph 7,a7 %all be con/ru$ to    
prev5t ! ,secret>y f revalu+ misvalu$   
codes = specific s]vices or assign+     
values to new or revis$ codes = s]vices4
  4  7b7 ,adju/m5t to conv]sion factor  
,section #ahdh7;d77#bj7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;d77#bj77 is am5d$--  7#a7 by 
/rik+ #j4ge p]c5t & ins]t+ #a4bd p]c5t2 
7#b7 by /rik+ #j4be p]c5t & ins]t+ #j4gd
 p]c5t2  7#c7 by /rik+ ,= #bjbf & ea*   
subsequ5t ye> & ins]t+ ! foll[+3  7,a7  
,update = #bjbf ,= #bjbf  2 &  7#d7 by  
add+ at ! end ! foll[+ new subp>agraph3 
7,b7 ,update = #bjbg & subsequ5t ye>s ,=

 #bjbg & ea* subsequ5t ye>1 ! update to 
! qualify+ ,,apm conv]sion factor       
e/abli%$ "u p>agraph 7#a77;,a7 is #j4ge 
p]c5t1 & ! update to ! nonqualify+ ,,apm
 conv]sion factor e/abli%$ "u su*       
p>agraph is #j4be p]c5t4  4