California Counties Would See Medicare Pay Hike Under Plan
In the coming weeks, Rep. Sam Farr (D-Calif.) will introduce legislation that would increase Medicare reimbursement rates for physicians in at least seven California counties, according to Rochelle Dornatt, Farr's chief of staff, the Santa Cruz Sentinel reports (Brown, Santa Cruz Sentinel, 4/17).
Under Medicare reimbursement rules, Santa Cruz and 40 other California counties are categorized as "rural," resulting in payments that are about 16% lower than reimbursements for providers in neighboring counties.
Some say lower reimbursement rates deter physicians from opening new practices in the counties and prompt many local physicians to accept fewer Medicare beneficiaries as patients (California Healthline, 4/14).
The proposal calls for physicians' Medicare reimbursements to be set using a method similar to how payment rates for hospitals are set, rather than based on geography.
The change would cost about $50 million annually but would result in lower reimbursement rates for other counties in Northern and Central California that Medicare has classified as rural.
Dornatt said the legislation would stipulate that Medicare payments remain at the same rate for several years to allow physicians to adjust to the lower rates.
The proposal comes after aides to Farr met with staff from House Speaker Nancy Pelosi's (D-Calif.) office and CMS yesterday (Santa Cruz Sentinel, 4/17).ÂA lawsuit challenging Medicare payment rates in the seven California counties is before the U.S. Ninth Circuit Court of Appeals in San Francisco (California Healthline, 4/14). 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.