Medicare Price Problems and the RUC: Wagging the Dog

7 St. Louis University Journal of Health Law & Policy 175 (2013)

26 Pages Posted: 2 Apr 2014

See all articles by David Fuchs

David Fuchs

Saint Louis University - School of Law

Date Written: 2013

Abstract

A recent suit brought against HHS and CMS alleged that the RUC disproportionately represents specialist physicians and argued that the RUC should be subject to review under the FACA. On August 8, 2011, six primary care physicians filed a complaint against CMS and HHS for ostensibly accepting recommendations made by the RUC without review and charged that the effects of the RUC’s recommendations have led to a significant gap between primary care physicians and specialists.

This case encapsulated an ongoing battle of primary care physicians, lobbyists, and politicians over the RUC’s vitality and nature. One of the physicians most essential points is that the exclusivity, privacy, and immunity by which the RUC operates when calculating the relative value units (RVU), which disproportionately reward specialist physicians over primary care physicians, is detrimental to the Medicare fee schedule and should be subject to scrutiny under the FACA.

Suggested Citation

Fuchs, David, Medicare Price Problems and the RUC: Wagging the Dog (2013). 7 St. Louis University Journal of Health Law & Policy 175 (2013) , Available at SSRN: https://ssrn.com/abstract=2418824

David Fuchs (Contact Author)

Saint Louis University - School of Law ( email )

100 N. Tucker Blvd.
St. Louis, MO 63101
United States

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