Today, Rep. Cindy Axne (IA-03) unveiled bipartisan legislation to ensure Iowa’s health care providers receive fair and adequate reimbursement for care they provide for Iowans.
Medicare uses geographic practice cost indices (GPCIs) to adjust physician reimbursement rates in each. While intended to reflect differences in the cost of physician wages, practice expenses, and malpractice insurance across the country, the way Medicare GPCIs are calculated has led to lower reimbursement for providers in Iowa.
The Keep Physicians Serving Patients Act would mandate that the physician work and practice expense GPCIs each be calculated using accurate, up-to-date data. Additionally, this legislation would set a universal floor for both the physician work and practice expense GPCIs, giving certainty to Iowa’s providers that their reimbursements will not be adjusted below a certain level.
“Since the beginning of the COVID-19 pandemic, we’ve seen each and every day just how important our health care providers are to keeping Iowans healthy and safe – and they deserve to be fairly reimbursed for that care,” said Rep. Axne. “Low Medicare reimbursement rates aren’t just making it harder for Iowa’s health care providers to keep their doors open. They’re also hurting our ability to recruit more folks to practice in Iowa, especially in our rural and underserved communities. I’m proud to be leading this bipartisan effort to make sure physician reimbursements recognize the cost of providing care not just in Iowa but across the country.”
By ensuring the use of accurate data and boosting reimbursement rates, this bipartisan legislation would strengthen Iowa’s ability to recruit and retain providers. In particular, ensuring that physician work and practice expense GPCIs are no lower than the national average of 1.0 will better reflect the costs of delivering care in rural communities across Iowa.
Last year, Rep. Axne voted to set the current national average as the floor for the physician work GPCI through the end of 2023. This legislation would extend that vital provision permanently, as well as expand the 1.0 floor on the practice expense GPCI, currently only offered to select states, nationwide.
The Keep Physicians Serving Patients Act is co-led by Reps. Darin LaHood (IL-18), Ron Kind (WI-03), Terri Sewell (AL-07), and Adrian Smith (NE-03).
“Too often, physicians in rural communities are not properly reimbursed by Medicare, contributing to our nationwide physician shortage and putting a strain on our rural health care systems,” said Rep. Sewell. “By requiring Medicare to use only the most accurate and recent data in determining reimbursement rates, the Keeping Physicians Serving Patients Act does exactly as its name suggests—ensures that those in Alabama’s 7th District and rural communities across the country have access to the quality, affordable health care they deserve.”
“Our physicians and health systems in rural Wisconsin provide high-quality care, but the flawed Medicare reimbursement formula is putting our providers at a disadvantage and harming rural health systems,” said Rep. Kind. “I’m proud to join my colleagues on both sides of the aisle to work to fix the GPCI formula and give our rural communities a fair shake when it comes to Medicare reimbursement.”
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