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CMS-1403-FC
1-year period. We intend to provide a detailed analysis of
BN and the proposed offset during the CY 2010 PFS
rulemaking process.
The following is a summary of the public comments we
received and our responses.
Comment: We received one comment concerning the
methodology for determining BN. The commenter stated that
the Congressional intent for implementing BN is clearly
spelled out in section 651(f)1)A)of the MMA. The commenter
believes the demonstration’s costs should be offset from
the totality of services payable under the Part B Trust
Fund, and not a discrete minority of services. The
commenter stated that our methodology is flawed because it
offsets demonstration costs only from existing chiropractic
services.
Response: Section 651(f)1)A) of the MMA requires that
“* * * the Secretary shall ensure that the aggregate
payment made by the Secretary under the Medicare program do
not exceed the amount which the Secretary would have paid
under the Medicare program if the demonstration projects
under this section were not implemented.” The statute does
not specify a specific methodology for ensuring BN. Our
methodology meets the statutory requirement for BN and
appropriately impacts the chiropractic profession that is
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