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<strong>CMS</strong>-1403-FC<br />

requirement by making a separate adjustment to the work<br />

RVUs.<br />

Section 133(b) of the MIPPA amends section<br />

1848(c)(2)(B) of the Act to specify that the BN adjustor<br />

for the 5-Year Review must be applied to the conversion<br />

factor beginning with CY 2009. Further discussion of this<br />

MIPPA provision as it relates to the CY 2009 PFS can be<br />

found in section IX. of this final rule with comment<br />

period.<br />

F. Section 134: Extension of Floor on Medicare Work<br />

Geographic Adjustment Under the Medicare Physician Fee<br />

Schedule<br />

In accordance with section 103 of the MMSEA, the 1.000<br />

work GPCI floor was set to expire as of July 1, 2008.<br />

Section 134(a) of the MIPPA extended the 1.000 work<br />

geographic practice cost index (GPCI) floor from<br />

July 1, 2008 through December 31, 2009. Additionally,<br />

section 134(b) of the MIPPA sets a permanent 1.500 work<br />

GPCI floor in Alaska, beginning January 1, 2009. As such,<br />

the CY 2009 GPCIs and summarized GAFs reflect these<br />

statutorily mandated work GPCI floors.<br />

G. Section 136: Extension of Treatment of Certain<br />

Physician Pathology Services Under Medicare<br />

827

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