Gulf in Medicare Payments Impacts Central Coast
The San Luis Obispo County Board of Supervisors "did the right thing this week by joining five other counties in a legal battle to increase Medicare reimbursement" to physicians, a San Luis Obispo Tribune editorial states (San Luis Obispo Tribune, 5/3).
The five counties in March filed a claim against HHS seeking to recover $2.4 billion in Medicare underpayments for health care providers nationwide over the past six years. Of that amount, $281 million would go to the five California counties that brought the claim (California Healthline, 4/4).
CMS incorrectly classifies the counties, including San Luis Obispo, as rural areas with lower costs of living than counties that are classified as urban, according to the Tribune. As a result, physicians "receive lower Medicare reimbursements than [physicians] in urban areas," the editorial states.
According to the editorial, the payment disparity exacerbates a physician shortage in many counties and discourages physicians in the area from participating in Medicare, an "especially troubling" situation given the aging baby boomer population.
If the counties' claim is denied, "the next step would be for the counties to sue the federal government" and "remedy an unjust -- and potentially deadly -- situation," the Tribune states.
"The health risks that our neighbors, families and friends will face if the Feds maintain a deaf ear to our Medicare-less condition are simply unacceptable," the Tribune states (San Luis Obispo Tribune, 5/3).