Farr's Medicare GPCI Fix heads to President's desk

Press Release

The Senate today voted 64-35 to pass Rep. Sam Farr's, D-Carmel, bill to permanently fix the underpayment by Medicare to California doctors who practice in certain counties. The bill now heads to the White House where President Obama is expected to sign it. Farr's Geographic Practice Cost Index (GPCI) Fix would solve a four-decade-old problem that mislabels 14 California counties as "rural," meaning doctors are under compensated for Medicare procedures. Monterey, San Benito and Santa Cruz Counties are among those affected by this problem.

"Perseverance has paid off! For nearly 15 years, we have been diligently working to fix this problem," said Farr. "Now doctors all over California will be fully reimbursed for seeing Medicare patients. More doctors will want to practice here; expanding access to quality healthcare not just for seniors but for everyone."

In 1966, when the formula was initiated, counties were designated as either "rural" or "urban," with the expectation that those designations would be updated every few years. That never happened, and as a result, doctors in counties that have seen economic growth are being compensated at levels significantly lower than those in nearby counties. For instance, counties such as San Diego and Sacramento are improperly designated as "rural' despite large populations. The 14 California counties (San Benito, Santa Cruz, Marin, Santa Barbara, San Diego, Monterey, Sonoma, Placer, El Dorado, Yolo, Sacramento, San Luis Obispo, Riverside and San Bernardino) are underpaid by as much as 10% each year, forcing doctors practicing in those counties to forgo up to $54 million in Medicare funding each year.

Farr's GPCI Fix would require the reimbursement formula to be calculated based on Metropolitan Statistical Areas (MSAs), which better reflect the cost of practicing medicine. Medicare already uses MSAs for hospital payments. The higher payments would be phased in over a six-year period starting in 2017.

"From the beginning this has always been about ensuring access to doctors for everyone," said Farr. "Seniors now have the assurance that more doctors will treat them and doctors know they will be properly reimbursed for providing that care, allowing them to practice in all counties. This is a huge win for California!"

The GPCI Fix was included as part of H.R. 4302, a bill to extended Medicare payments through the end of the 2014. Both California Senators voted for the bill. The House of Representatives passed the legislation by voice vote on March 27, 2014.

Source