4 ▁to ▁take ▁effect ▁in ▁ 2 0 1 5 . ▁If ▁the ▁Board ▁failed ▁to ▁submit ▁a ▁proposal ▁that ▁the ▁Chief ▁Act u ary ▁cert ifies ▁would ▁achieve ▁the ▁sav ings ▁target , ▁the ▁Secretary ▁of ▁Health ▁and ▁Human ▁Services ▁was ▁to ▁submit ▁a ▁proposal ▁that ▁would ▁achieve ▁that ▁amount ▁of ▁sav ings . ▁ ▁The ▁Secretary ▁was ▁then ▁to ▁implement ▁the ▁proposal ▁unless ▁Congress ▁en act ed ▁resolution s ▁to ▁override ▁the ▁Board ' s ▁( or ▁the ▁Secretary ' s ) ▁dec isions ▁under ▁a ▁fast - track ▁procedure ▁that ▁the ▁law ▁set ▁forth . ▁ ▁A ▁related ▁group , ▁the ▁Special ty ▁Society ▁Rel ative ▁Value ▁Sc ale ▁Update ▁Committee ▁( or ▁Rel ative ▁Value ▁Update ▁Committee ; ▁R UC ), ▁composed ▁of ▁phys icians ▁associated ▁with ▁the ▁American ▁Medical ▁Association , ▁also ▁advis es ▁the ▁government ▁about ▁pay ▁standards ▁for ▁Medic are ▁patient ▁procedures , ▁according ▁to ▁news ▁reports . ▁ ▁On ▁February ▁ 9 , ▁ 2 0 1 8 , ▁the ▁United ▁States ▁Congress ▁voted ▁to ▁repe al ▁the ▁Independent ▁Pay ment ▁Ad vis ory ▁Board ▁as ▁a ▁part ▁of ▁the ▁B ipart isan ▁Bud get ▁Act ▁of ▁ 2 0 1 8 , ▁by ▁a ▁vote ▁of ▁ 7 1 − 2 8 ▁in ▁the ▁US ▁Senate ▁ ▁and ▁by ▁a ▁vote ▁of ▁ 2 4 0 − 1 8 6 ▁in ▁US ▁House ▁of ▁Representatives . ▁Short ly ▁there after ▁that ▁day , ▁President ▁Trump ▁signed ▁the ▁budget ▁bill ▁into ▁law , ▁thereby ▁repe