SDCMS-CMA at Work

Though not immediately successful, this letter — sent by a majority of California congressmen and women to Chairman Thomas of the Committee on Ways & Means — was the direct result of strong and persistent advocacy by SDCMS-CMA on behalf of California’s and the nation’s physicians!

December 13, 2005

The Honorable William M. Thomas
Chairman
Committee on Ways & Means
1102 Longworth HOB
Washington, D.C. 25015

Dear Chairman Thomas:

We are writing to urge you, as a conferee on the Budget Reconciliation Act, to address the crucial Medicare physician payment issues before the Conference Committee. Specifically, we ask that you stop the projected Medicare physician payment cuts, which will total 26% over the next six years while physician practice costs increase 15%. As you are aware, all other providers participating in the Medicare program are receiving payment increases (as shown in the chart below), except physicians, due to a flawed physician payment formula.

2006 Medicare Provider Payment Updates:

• Physicians -4.4%
• Health Plans +4.8%
• Hospitals +3.7%
• Home Health +3.3%
• Nursing Homes +2.7%

We respectfully urge you to adopt a payment update that truly reflects the costs to practice medicine and thereby preserves seniors’ access to doctors. 60% of the physicians responding to a California Medical Association survey said they would be forced to stop accepting new Medicare patients if the cuts go into effect — almost double the national response. 40% said they could be forced to quit Medicare altogether. These cuts have a devastating impact in California where access is already a problem.

In addition, physicians in our state and many other states are experiencing serious inequities in their Medicare geographic payments. Over the past several years, counties across the country have become more urbanized and therefore, practice costs have increased. However, because of Medicare’s geographic locality requirements, physicians in these transitioning counties cannot be reimbursed for their higher practice costs without reducing payments to physicians in rural areas. CMS has left the Medicare payment locality issues unattended for almost a decade. Therefore, some physicians are being paid as much as 10% less than Medicare’s own geographic formula says they should be paid. We urge you to adopt the following Medicare Geographic Payment Locality proposal because it would improve access to physicians in areas with dramatically changing demographics without penalizing senior access in rural areas. The cost is a minor $115 million to fix nearly ten years of neglect.

Allow any county whose geographic costs exceeds its Medicare Payment Locality costs by 5% to move to its own individual county Medicare Payment Locality and be reimbursed according to its individual costs.

Hold harmless physicians in counties remaining in the originating Medicare Payment Locality at their 2006 Medicare payment levels plus any SGR updates.

Thank you for your consideration of these crucial Medicare issues.

Sincerely,

Rep. Sam Farr

Rep. Darrell Issa

Rep. Susan Davis

Rep. Jane Harman

Rep. Bob Filner

Rep. Dan Lungren

Rep. Elton Gallegly

Rep. Dana Rohrabacher

Rep. Tom Lantos

Rep. Doris Matsui

Rep. Howard P. “Buck” McKeen

Rep. Howard Berman

Rep. Ed Royce

Rep. Ken Calvert

Rep. Wally Herger

Rep. Lynn Woolsey

Rep. Jerry Lewis

Rep. Lois Capps

Rep. Mike Honda

Rep. Grace Napolitano

Rep. Hilda Solis

Rep. Loretta Sanchez

Rep. Xavier Becerra

Rep. Brad Sherman

Rep. Ellen Tauscher

Rep. Dennis Cardoza

Rep. Joe Baca

Rep. Mike Thompson

Rep. Mary Bono

Rep. Anna Eshoo

Rep. Gary Miller