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Much of what is said by critics of the RUC process is at best incorrect and at worst purposely misstated.
Dr. Gee, a member of the Urology Times Editorial Council, is in private practice in Lexington, KY. He is the alternate AUA representative to the AMA Relative Value Scale Update Committee and works with Thomas Cooper, MD, who is the AUA RUC representative, and Norm D. Smith, MD, and Thomas M.T. Turk, MD, who are AUA RUC advisers.
In 1989, President George H. W. Bush signed the bill that authorized implementation of the Resource Based Relative Value Scale, or RBRVS. On Jan. 1, 1992, the law went into effect and the way physicians were paid was drastically altered, fees went down, and physicians became "a resource."
The law requires annual updates to the relative values, and rather than let the government (CMS) have total control, the American Medical Association stepped in and formed a committee of physicians representing the major specialties, including urology, to review the relative values and petition the government with its findings under our First Amendment rights. This committee is called the Relative Value Update Committee of the AMA, better known as “the RUC.”
Scott Baltic's article offers a well-balanced discussion about the RUC and how it has become a lightning rod for some primary care physicians who think they are not paid enough. Much of what is said by critics of the RUC process is at best incorrect and at worst purposely misstated.
I have represented the AUA on this committee on and off from 1995 to the present. The role of our AUA team has been to make sure that urology procedures are given fair and equitable “relative values” that are “relatively the same” when compared to procedures in other specialties with similar times and difficulty.
Most urologists are not members of the AMA, but were it not for the foresight of the AMA in creating the RUC and its continuing support of the RUC, we would all be much worse off. Not only Medicare, but private payers as well, look to the relative values in negotiating contracts, and for many of you, your “productivity” is judged by the number of relative value units you produce. The RUC is a vital part of the physician reimbursement system; the accompanying article is a must read.UT
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