One local doctor is hopeful proposed legislation will fix a disparity with county Medicare reimbursements he believes are unfair. “Because of this (rate), doctors in Hollister that see Medicare patients get paid 15 percent less than doctors in Gilroy who do the same work,” said Dr. Martin Bress of Hazel Hawkins Memorial Hospital.
One local doctor is hopeful proposed legislation will fix a disparity with county Medicare reimbursements he believes are unfair.
“Because of this (rate), doctors in Hollister that see Medicare patients get paid 15 percent less than doctors in Gilroy who do the same work,” said Dr. Martin Bress of Hazel Hawkins Memorial Hospital.
Congressman Sam Farr, D-Carmel, helped push the House Ways and Means Committee to include a “fix” to doctor payments in the Central Coast region, including in San Benito County.
Farr pointed out that in recent years, doctors in San Benito County who treat Medicare patients have had their payments lowered between 4 percent and 14 percent compared with other California doctors because of an error in the payment formula – known as the Geographic Cost Practice Index. As a result, those doctors have had to turn away potential patients in the county. The legislation would raise payments for doctors in both San Benito and Santa Cruz counties.
“I am really happy that the committee agreed that our doctors were getting a raw deal and used this opportunity to fix the problem,” Farr said in a statement.
The legislation now goes to the full House of Representatives for consideration when Congress returns in January.
In 2007, Farr had proposed a similar bill that would have kept reimbursement rates from falling in San Benito County, even as doctors in the county criticized the move because it left them with lower Medicare payments than surrounding counties. Farr defended the vote at the time by suggesting that the rates would have fallen even further for the county if not for his legislation.
With the new formula, Bress is “cautiously optimistic” those disparities for doctors will be fixed. He said county doctors and the California Medical Association have been working with Farr for a decade to fix the payment structures. The federal government is now correcting how it labels the Central Coast counties in its records, he said.
“They (Central Coast counties) have been listed as rural counties with a low wage base and low overhead, which is just not true,” he said.
Bress praised Farr as a “champion” for the doctors’ cause, but he wouldn’t stop pushing the congressman on the issue.
“Until it’s done, we’re not celebrating,” he said.
