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| Wilson Introduces Bill to End Medicare Payment Discrimination for New Mexico |
February 12, 2003 |
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Legislation equalizes Medicare funding formula for physicians
Washington, DC--Congresswoman Heather Wilson introduced a bill today to end discrimination against states like New Mexico that are not treated fairly under Medicare reimbursement formulas. These formulas penalize rural states and states that have efficient health care systems.
Wilson introduced a similar bill last year and was successful in attaching a provision to the Prescription Drug bill that passed the House that would move Medicare toward greater equity. Senator Domenici is introducing a companion bill in the Senate. The bill will bring all localities currently below the 1.00 rate immediately to a 1.00 floor beginning FY 2004.
“New Mexicans don`t pay into Medicare based on where they live. And they should not be denied access to health care because of where they live,” said Wilson. “Thousands of New Mexicans rely on Medicare for their healthcare, and most private insurance companies tie their reimbursement rates to what Medicare will pay. These reimbursement schedules that pay doctors more for the same service in other states is one reason why we are losing doctors in New Mexico.”
“The growing physician shortage in New Mexico is contributing to a building health care crisis for hospitals and patients in our state. The combination of New Mexico’s high poverty levels and low Medicare reimbursement rates only makes it harder for us to recruit and retain physicians,” Domenici said. “This bill would help raise our state’s notoriously low reimbursement rates so that good doctors will keep practicing in New Mexico, thereby making patients the ultimate beneficiaries.”
Medicare has reimbursement schedules for over 7,000 different procedures or services provided
by Doctors. Each service is adjusted by a formula that includes a geographic factor in different counties. For all procedures and reimbursements combined, in fiscal year 2000, the Federal government paid $3,726 per enrollee for Medicare in New Mexico. They paid $6,539 per enrollee in Texas, $5,100 in Colorado, and $4,464 in Arizona. Only 5 states or territories were reimbursed less per enrollee than New Mexico -- Puerto Rico, Vermont, Virgin Islands, Iowa, and Maine.
Following are examples of reimbursement rates by locale for certain procedures:
Procedure Albuquerque Flagstaff, AZ Miami, FL Denver, CO New York, NY
Hysterectomy $844.16 $889.73 $1000.76 $873.71 $1081.96
Office Visit $57.22 $60.95 $66.23 $60.56 $75.50
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