Groups Criticize Proposal To Address Medicare Reimbursement Disparity Among California Counties
The San Jose Mercury News on Sunday examined criticism of the variance in Medicare reimbursements by county and an Aug. 8 proposal to change reimbursement rates in Santa Cruz and Sonoma counties.
California counties are classified as either urban or Locality 99. Urban counties are reimbursed according to specific local costs, while reimbursement rates in Locality 99 counties are determined by the average costs of all Locality 99 counties, despite a cost of living variance among those counties.
For example, Medicare reimbursement rates are 10% to 12% lower than the cost of practicing in Santa Cruz County, which Medicare classifies as Locality 99, according to Larry deGhetaldi, director of the Santa Cruz Medical Foundation. DeGhetaldi said the difference is the highest in the state. He said that reimbursement rates in nine counties are at least 5% lower than the cost of care.
The California Medical Association and Reps. Sam Farr (D-Calif.) and Anna Eshoo (D-Calif.) in 2004 proposed a plan that would have changed reimbursement rates in the nine underpaid counties, but Medicare rejected the plan, the Mercury News reports.
Rep. Bill Thomas (R-Calif.) has said he will seek to change the reimbursement rates in all of the counties, rather than just Santa Cruz and Sonoma counties, by the end of the current Congress (Beck, San Jose Mercury News, 9/25).