About this series

This is one of a series of ongoing articles on how the government relies on doctors to help determine payments they receive as reimbursement for treating patients on Medicare. Since 1991, an obscure committee of doctors has had a large hand in determining how much Medicare pays by making a case for the underlying value of their services. The committee's recommendations generally are accepted by the Centers for Medicare and Medicaid Services, the agency within the Department of Health and Human Services that manages the programs. 

The committee, sponsored by the American Medical Association, is known as the Specialty Society Relative Value Committee, or RUC. Doctors on the committee are nominated by physician specialty societies; the American College of Cardiology, for instance, designates a heart doctor to serve on the panel. The AMA says doctors simply are exercising their First Amendment right to petition the government. Others argue that because doctors are, in effect, helping set reimbursement rates, the committee’s influence on Medicare is a clear conflict of interest. The argument is that the role of doctors has skewed payments in favor of specialists, while leaving family doctors behind.

More stories on this topic can be found here.