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William C. Hsiao, PhD
Harvard University Cambridge, Mass

JAMA. 1992;268(23):3313.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—Dr Tennant's letter contains erroneous reasoning, half-truths, and unsubstantiated charges. They have to be answered. The RBRVS is based on the resource costs required to perform each service. He states that a "fair" test for the RBRVS is whether it produces fees higher than the discounted charges that Medicaid and HMOs pay to physicians. His test is not valid. If a charge for a service is much higher than the resource costs involved, then a discount on that charge would not necessarily produce a charge lower than resource costs.

Tennant offers a half-truth when he states that we erred in our initial determination of the ophthalmological RBRVS and that we would only restudy them when the AAO had paid us $250 000. This is not the case. The AAO challenged our original findings on the grounds that some ophthalmological services were highly specialized and most general ophthalmologists sampled . . . [Full Text PDF of this Article]

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