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ask.heather@mail.house.gov
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In Washington DC
442 Cannon House
Office Building
Washington, DC
20515
202-225-6316 Phone
202-225-4975 Fax |
In Albuquerque
20 First Plaza NW
Suite 603
Albuquerque, NM
87102
505-346-6781 Phone
505-346-6723 Fax |  |
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Congresswoman Heather Wilson, First Congressional District of New Mexico
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| Wilson Attaches Amendment to Prescription Drug Bill to Equalize Medicare Funding for Physicians |
June 21, 2002 |
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Prescription Drug Bill Passes Out of Committee After a Marathon Session
Albuquerque, NM-Amidst growing concerns that doctors are fleeing our state for higher paying positions in other states, Congresswoman Heather Wilson introduced an amendment early this morning that will level the playing field and equalize payments to doctors in rural states like New Mexico. The amendment will increase the lower limit of geographic adjustment for physicians’ services under the Medicare Program. By doing so, it will increase the equity in payment for physicians practicing in rural areas.
“Seniors in New Mexico didn’t pay any less into Medicare than seniors in New York or California or Texas,” says Wilson, who in the 106th Congress successfully lobbied to increase reimbursement rates for Medicare Choice programs. “Doctors who treat New Mexicans in New Mexico shouldn’t receive less for their work. That does nothing but hurt healthcare in our state, which in turn hurts seniors and everybody who relies on our healthcare system.”
Physicians fees are made up of 3 separate components: work, the expense of running a practice, and malpractice insurance. About 14% of the average physician’s Medicare reimbursement is adjusted based on the value of their wages in the area where they practice. Wilson’s amendment will raise the geographic adjuster to .985 for physician work component of the physician fee schedule and will result in approximately 33 localities across the country receiving higher reimbursement rates without harming any other localities.
“Seniors, in particular, rely on medical care more than others,” says Wilson. “An archaic formula tells us that a doctor’s time in New Mexico is worth less than elsewhere, and that’s just not true. We need to fix that for New Mexico because that impacts real people, not statistics.”
Wilson’s amendment is part of The Medicare Modernization and Prescription Drug Act, a bill that will strengthen and improve Medicare and provide America`s elderly with a lifetime prescription drug benefit.
Specifically, the Prescription Drug Act includes:
An affordable and permanent prescription drug benefit for as little as $35 a month available to all seniors. This is a voluntary program that guarantees seniors` the ability to choose among plans to find what works best for their prescription needs.
Standard benefit that begins with a $250 deductible and pays 80% of spending up to the first $1,000 and 50% up to $2,000. Seniors who meet the low-income criteria (64% of New Mexico’s seniors are currently without coverage) will pay less than $5 per prescription, up to coverage limits. All participants are protected against catastrophic costs, with out-of-pocket expenditures capped at $4,500 per year.
Immediate savings to seniors through an interim discount card program.
Stabilizing Medicare Choice increases New Mexico’s payments by 3%.
Increasing incentives for providers to serve patients in rural areas and communities, which are essential to ensure that people everywhere have access not only to the prescription medicines they need, but also the best medical care possible.
Beefing up payments to community, rural and small urban hospitals.
“No one should be forced to choose between buying food or buying medicine,” said Wilson. “While prescription drugs have helped millions of senior citizens improve their quality of life, the costs of these cutting-edge, life-saving medicines also have skyrocketed - putting a particular pinch on those living on a fixed-income. We can help these seniors get the prescription drugs they need to live a long, happy life.”
The Medicare Modernization and Prescription Drug Act passed out of Committee and is expected to be considered on the House floor next week.
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