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.”