Legislation Introduced To Tackle California's GPCI Problem, Raise Medicare Rates In Certain High-Cost Counties

Main Category: Medicare / Medicaid / SCHIP
Article Date: 14 Jun 2009 - 1:00 PDT

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U.S. Rep. Sam Farr (D-Calif.) and Sen. Dianne Feinstein (D-Calif.) introduced legislation sponsored by the California Medical Association to eliminate one of the biggest barriers for seniors to get access to health care - low Medicare reimbursement rates in several counties.

The low rates have forced many doctors to opt out of Medicare or limit the patients they take through the program. The net result is in several counties currently classified as rural under the formula that sets the rates, the federal government's Geographic Practice Cost Index (GPCI), Medicare recipients have a difficult time finding a doctor to treat them.

"This is a welcome breakthrough on a problem that has reduced access to care for years," said Dr. Dev A. GnanaDev, president of the California Medical Association. "As costs have risen in places like Santa Cruz, Sacramento and San Diego counties, Medicare reimbursements have not kept up, and that has resulted in fewer doctors being able to serve those patients. This legislation provides a fix without punishing other counties. CMA applauds the efforts of U.S. Rep. Sam Farr and Sen. Dianne Feinstein to ensure California's seniors have access to health care."

Under GPCI, 47 of California's counties share the same rural classification and reimbursement rates despite having significantly different costs of living and doing business. Many of California's counties under the rural designation, from San Diego to Santa Cruz, have grown rapidly in recent years and have much higher costs of living than other rural regions.

The legislation would place California localities into up-to-date Metropolitan Statistical Areas (MSAs), which more accurately reflect regional costs, and hold all counties that might experience cuts harmless from a payment reduction by such a change. By doing this, many areas qualify for higher rates. The 14 counties affected are: El Dorado, Monterey, Placer, Riverside, Sacramento, San Benito, San Bernardino, San Diego, San Joaquin, San Luis Obispo, Santa Barbara, Santa Cruz, Sonoma and Yolo counties.

The California Medical Association represents more than 35,000 physicians in all modes of practice and specialties. CMA is dedicated to the health of all patients in California.

Source
California Medical Association