Congressman Adam Smith (D-Wash.-09) today introduced legislation alongside Senator Patty Murray (D-Wash.) to rectify the nation’s Medicare reimbursement rate inequalities.  The legislation is co-sponsored by Washington Representatives Norm Dicks (D-06), Jim McDermott (D-07), Brian Baird (D-03), Jay Inslee (D-01), and Rick Larsen (D-02). 

The federal Medicare system, which covers health care for the nation’s senior citizens, works by reimbursing doctors, hospitals, home health care, nursing homes - and in the case of the Medicare + Choice system, HMO’s - for the services they provide to Medicare recipients.

Washington state has been hit especially hard by cuts to the Medicare program and many insurance companies are dropping out of the program because discrepancies in reimbursement rates from state to state, even from county to county, have left very few economic incentives for participation.  

Washington state’s rates are low because the state worked very hard to be efficient and eliminate waste and fraud from the Medicare program and as a result, was locked into one of the lowest Medicare provider reimbursement rates in the country. A managed care organization receives a base reimbursement rate of $465.97 for a Medicare patient in Pierce County but $809.90 for a Medicare patient in Dade County (Miami, Florida).

H.R. 4850, The MediFAIR Act will ensure that Washington’s seniors are treated on par with seniors around the country.  It will stop punishing our state’s health care system and our seniors and instead reward the efficiency and good results we’ve produced.

The bill will increase Washington’s reimbursement rates to the national average and direct the Secretary of Health and Human Services to require other states to become more efficient and cut waste in their health care systems.

“I strongly believe that we need a long-term solution to our Medicare problem.  We have to face the reality that we have a ‘perfect storm’ brewing: health care inflation is rising quickly, and, as the baby boomers retire, we’ll have an enormous influx of seniors into the program and health care costs are continuing to grow,” Smith said.  “We need fundamental reform that focuses on healthy outcomes, gives seniors health care options, provides coverage for prescription drugs, and ensures the program is viable for future generations.  The MediFAIR Act is a good first step, ensuring that all our seniors are treated fairly.”

Congressman Adam Smith (D-09) will spend May 28 talking with constituents and healthcare experts about Washington state’s Medicare problems.  The following is the schedule of events for the day:  

Members of the media are invited and encouraged to attend these meetings.  For further information or to speak with Smith during the day, please contact Katharine Lister in the district on cell at (202) 225-6902.

10:00a.m. – 11:00a.m. Press Conference with Senator Murray, Representatives Norm Dicks (D-06), Jim McDermott (D-07) and Brian Baird (D-03) to talk about legislation to ensure that Washington’s seniors are treated on par with seniors around the country.   

Where: Group Health Hospital 
201 16th Ave East, Capitol Hill, Seattle 
6th floor of the main building

12:00 noon - 1:30p.m. Medicare Roundtable lunch hosted by Smith to talk about the next generation of Medicare reform – reimbursement rates, issues of access to quality care and feasibility of a Medicare prescription drug benefit are some of the issues to be discussed.  Participants in the roundtable include doctors, insurance providers, hospital administrators and senior advocates.  If you would like to attend the lunch, please contact Katharine Lister as soon as possible to ensure that there will be a lunch provided for you.

Where: Valley Medical Center 
400 South 43rd Street, Renton 
Board of Directors Conference Room

2:30p.m. – 3:15p.m. Smith meets with one hundred residents of Wesley Homes Retirement Community in Des Moines about Medicare and their needs and concerns with the program.  

Where: Wesley Homes Retirement Community
815 South 216th Street, Des Moines 
Gardens Building