Language Included in Appropriations Bill Directs HHS to Correct Sonoma County’s Low Medicare Reimbursement Rates

WASHINGTON, DC— Congress today approved a key appropriations bill that would correct low Medicare reimbursement rates for physicians in Sonoma County. Under language requested by Sonoma County Representatives Mike Thompson and Lynn Woolsey, the federal Center for Medicare and Medicaid Services must present a plan to Congress by January 1 for fixing a decades old discrepancy in the reimbursement rates paid to doctors in Sonoma and three other California counties.

“Remedying this inequity is the single most important way we can pump more money into our ailing health care system,” said Thompson. “Private insurers and health plans peg their rates to what Medicare is paying so this should raise the bar across the board.”

Physicians have long pointed to the low reimbursement rate in comparison to the high cost of practicing medicine in Sonoma County as one of the chief reasons for the doctors leaving the area and for the failure of several medical groups.

“It’s about time the Federal Government committed to Sonoma County’s health care reimbursement inequities,” said Rep. Woolsey. “In helping Sonoma County, we have also helped other California areas.”

The language in the Labor/Health and Human Services spending bill codifies an understanding reached by the CMS Administrator Tom Scully at a meeting with Sonoma County physicians arranged by Thompson and Woolsey last year. He acknowledged that local physicians should be receiving higher pay for their services but that a remedy may take years to accomplish.

“The Sonoma County health care community has done an excellent job in making the case that the unfairness of Medicare reimbursements must be resolved,” said Rep. Woolsey.

“Hopefully we’ve moved that timeframe forward a bit,” said Thompson.

The Senate has not yet considered its version of the bill.