Set the national fee schedule

Months 3–15; annual updates thereafter · Payment Rates Board; UHADiscuss this step

Every concrete action this step requires, who is responsible, and when it happens relative to enactment.

#	Action	Owner	When	Trade-off
1.7.1	Start from the CY Medicare Physician Fee Schedule (about 10,000 codes) and apply specialty-group multipliers.	Rates Board	Month 3–9	Using Medicare's RBRVS as the base is fast but inherits its known distortions favoring procedures.
1.7.2	Create fee schedules for services Medicare doesn't pay for: dental (CDT codes priced at 95% of the average private fee), pediatric and obstetric codes, vision, and hearing.	Rates Board	Month 3–12	Pricing dental at 95% of average private fees attracts dentists but costs more than Medicaid dental rates.
1.7.3	Adopt a geographic practice-cost index (GPCI) and a rural add-on of 10%.	Rates Board	Month 6	A rural add-on protects access but raises cost and can be gamed by redefining 'rural'.
1.7.4	Publish 4-year convergence paths: each provider's payments move 25% per year from its current blended rate to the UHP rate.	UHA	Month 9	Four-year convergence cushions specialists but delays savings.
1.7.5	Re-value overpriced procedures: commission an independent review of RVU inputs, which are currently developed largely by the AMA's RUC.	Rates Board	Months 6–24	Independent RVU review corrects overpricing but removes physicians' influence over their own fees.
1.7.6	Offer primary-care capitation: a per-patient monthly payment covering 70% of expected revenue, plus fee-for-service for the rest, for practices that opt in.	UHA	Month 15	Primary-care capitation rewards keeping patients healthy but can encourage under-treatment.