[3] Third-party payers (public and private health insurance) advocated an improved model to replace the UCR fees, which had been associated with stark examples of specialists making significantly higher sums of money than primary care physicians.
[4] With reference to the research of William Hsiao and colleagues,[5] the Omnibus Budget Reconciliation Act of 1989 was passed with the legislative intent of reducing the payment disparity between primary care and other specialties through use of the resource-based relative value scale (RBRVS).
[6] The AMA sponsors RUC "both as an exercise of 'its First Amendment rights to petition the Federal Government' and for 'monitoring economic trends ... related to the CPT [Current Procedures and Terminology] development process".
[7] RUC is highly influential because it de facto sets Medicare valuations of physician work relative value units (RVUs)[1] of Current Procedural Terminology (CPT) codes.
[1] The physician work RVU values accepted by CMS also influence private health insurance reimbursement.
[7] In 2002, a RUC update of values raised concerns that the process, which was initiated by medical speciality groups, unfairly cut primary care physician pay.
RUC chairperson Levy said in the report, "None of us believe the numbers are fine-tuned.... We do believe we get them right with respect to each other" while emphasizing that the "voting people around that table can be really harsh".