Inherent Reasonableness

Inherent Reasonableness

The Balanced Budget Act of 1997 expanded HCFA authority to adjust payment levels that it considered “inherently unreasonable,” either because it found them “grossly excessive” or “grossly deficient.” The law specified that payment for a service could not be changed by more than 15 percent in any year, unless the agency determined that certain criteria were met and unless it solicited public input.