Proposed Change to Medicare Reimbursement Rule Would Increase Rates in Some Counties, Decrease in Others

Under a rule change scheduled to take effect next year, doctors in Santa Cruz and Sonoma counties could receive a 10% increase in reimbursements from CMS for treating Medicare and Medi-Cal beneficiaries while doctors in Monterey County could see a corresponding decrease in reimbursements to offset the funding shift, the Monterey County Herald reports.

Supporters of the proposal, which should be finalized by Nov. 1, say that the cost of practicing medicine is higher in Santa Cruz and Sonoma counties than in other California counties and that many doctors are choosing to move their practices out of the area.

However, the Monterey County Medical Society has criticized the plan, saying it does not address disparities in Monterey and other high-cost counties. MCMS President Scott Schneiderman said the cost of practicing in some parts of Monterey County is the same as in Santa Cruz County.

Meanwhile, Monterey County has a higher cost of living than other counties with the same Medicare and Medi-Cal reimbursement rates, including Kern and Tulare counties.

According to the Herald, the California Medical Association has proposed that doctors statewide accept a small cut in reimbursements to help increase payments to doctors in high-cost communities, including Monterey County. However, the proposal has stalled.

The public can comment on the proposed rule change until Sept. 30 (Purewal, Monterey County Herald, 9/3).