California Counties Challenge Medicare Payment Categories
Seven California counties this week filed a lawsuit in federal court alleging that CMS' Medicare payment classifications result in local physicians being underpaid, the Ventura County Star reports (Kisken, Ventura County Star, 6/7).
The plaintiffs said CMS unfairly classifies the counties as rural, which results in lower Medicare reimbursements than urban regions.
The counties bringing the suit are:
- San Diego;
- Santa Cruz;
- Santa Barbara;
- San Luis Obispo; and
- Monterey counties.
Medicare officials could not be reached for comment after the lawsuit was filed on Monday (Clark, San Diego Union-Tribune, 6/5).
The lawsuit was filed three months after five California counties filed a claim against the federal government seeking to recover $2.4 billion in Medicare underpayments for health care providers nationwide over the past six years.
According to the claim, the pay disparity has forced physicians to stop accepting Medicare patients and has forced elderly and disabled beneficiaries to travel long distances to find a provider. The payment gulf occurred from 2001 to 2007, the claim states (California Healthline, 4/4).
KPBS' "KPBS News" on Monday reported on San Diego County's participation in the lawsuit. The segment includes comments from San Diego County Supervisor Ron Roberts (Goldberg, "KPBS News," KPBS, 6/4).
A transcript and audio of the segment are available online.
"It's silly that Medicare reimbursement rates are still being calculated based on formulas crafted in the 1960s," a San Jose Mercury News editorial states, adding that Congress should approve legislation by Reps. Lois Capps (D-Calif.) and Sam Farr (D-Calif.) that would modify Medicare reimbursement rates (San Jose Mercury News, 6/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.