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ACP-ASIM Pressroom

Practice Expense Fairness Coalition Urges Congress To Stay The Course—
Implement Resource-based Practice Expense (RBPEs) Without Delay

Sept. 18, 2000

Washington—The Practice Expense Fairness Coalition - representing a combined membership of over 400,000 primary care physicians, surgeons, and medical specialists -- reiterated its strong support today of implementing resource-based practice expenses (RBPEs), as mandated in the Balanced Budget Act of 1997 (BBA 97). The Coalition specifically expressed opposition to a new proposal that would delay implementation of RBPEs for another three years, except for a small number of office visit codes. The three-year delay proposal has been suggested by a different coalition of physicians that had been pushing for a halt to implementation of RBPEs.

"The old system of basing physician payments on historic charges undervalued most office-based procedures and overvalued procedures in facilities," said Bruce Bagley, MD, President of the American Academy of Family Physicians. "Primary care physicians, especially rural doctors and other office-based physicians - and their patients - were treated unfairly until BBA 97 mandated an equitable new payment system for physicians' practice expense."

The Practice Expense Fairness Coalition noted that a three-year delay suffers from the same shortcomings as a halt to implementation of RBPEs:

  • It would lock in existing inequities in payment.
  • It would adversely affect primary care physicians and other office-based physicians, particularly those in rural areas, which have been counting on the promised implementation of RBPEs to end the long-standing Medicare practice of undervaluing their services.
  • It would unnecessarily upset the compromise timetable for implementation mandated by the Balanced Budget Act of 1997.

The BBA 97 agreement on practice expense reconciled divergent interests, making it possible to move forward on phasing in a fair and equitable system over four years. The Practice Expense Fairness Coalition noted that substantial progress is being made under the current timetable, with multiple opportunities for refinement when supported by data. Finally, the Coalition reiterated its view that concerns over the adequacy of payments for physician services should be addressed by increasing the dollar conversion factor for the Medicare fee schedule, rather than by delaying or halting implementation of RBPEs.

"We are making good progress toward a fair and equitable physician fee schedule," Dr. Bagley said. "Let's keep on course to a fair physician fee schedule for all physicians."

Practice Expense Fairness Coalition Members: American Academy of Allergy, Asthma, and Immunology
American Academy of Dermatology
American Academy of Family Physicians
American Academy of Neurology
American Academy of Pediatrics
American College of Allergy, Asthma, and Immunology
American College of Physicians - American Society of Internal Medicine
American College of Rheumatology
American Society of Clinical Oncology
Joint Council on Allergy, Asthma, and Immunology
Renal Physicians Association
Society of General Internal Medicine


  • David Edelson, ACP-ASIM, 202 261-4575
  • Sarah Thomas, AAFP, 214-757-2103

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