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CMS-1403-FC
prescribing are described in section II.O2. of this final
rule with comment period.
Section 132(b) of the MIPPA also amends section
1848(a) of the Act to authorize the Secretary to apply a
hardship exception on a case-by-case basis to exempt
eligible professionals from the payment differential that
applies to those who are not successful electronic
prescribers by 2012. Since this hardship exception does
not apply until 2012, we will address the parameters that
we intend to apply to determine hardship through future
notice and comment rulemaking.
E. Section 133(b): Expanding Access to Primary Care
Services
Section 1848(c)(2)(B)(ii)(II) of the Act requires that
increases or decreases in RVUs for a year may not cause the
amount of expenditures for the year to differ by more than
$20 million from what expenditures would have been in the
absence of these changes. If this threshold is exceeded,
we must make adjustments to preserve BN.
The 5-Year Review of work RVUs would have resulted in
a change in expenditures that would exceed $20 million if
we made no offsetting adjustments to either the CF or RVUs.
In CY 2007 and CY 2008, we met the 5-Year Review BN
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