From Deseret News archives:
UTAH PHYSICIANS WANT NATIONAL FEE SCHEDULE
Federal Medicare discrimination against Utah physicians could result in inadequate medical care for senior citizens - the very folk Congress sought to protect when it created the health care program in 1966.
That's the message sent to Utah's congres-sional delegation from members of the Utah Medical Association - physicians who want to be reimbursed for their services at a rate in line with the national average.Specifically, they want a national fee schedule based on real costs of care. And Sen. Orrin Hatch, R-Utah, believes they should get it.
"I have always advocated national rates of payment under a DRG (iagnostic Related Group) system for inpatient hospital care," Hatch said in response to concerns from association president Dr. Anthony W. Middleton Jr. "And I agree with you that we need to advocate a national rate of payment for physician services or develop a more equitable formula that does not harm physician services in Utah."
The senator said he wants to discuss with association members ways to control costs, while ensuring physicians equitable reimbursement for their services.
"The Medicare program is very important and I want to ensure that seniors in Utah have access to quality and affordable care," he wrote.
Hatch's words should be music to physicians' ears.
Data collected by the Utah Medical Association's Equity Committee indicate that Medicare currently ranks Utah near the bottom in physician payments.
Middleton said part of the problem is that Utah contains just one Medicare charge locality, meaning that the maximum amount Medicare will reimburse for each procedure is the same for both urban and rural physicians, even though their operating costs greatly vary.
Most states are broken down into many localities. California, in fact, has 28, and Medicare's allowable fees vary for each locality.
Middleton said Utah's allowable Medicare fees are especially low for surgical procedures. Payments for office visits and primary care codes fare somewhat better, but are still low in comparison with the rest of the country.
"When prevailing fees for all codes are averaged, Utah ranks 12th from the bottom out of 117 charge localities," he stressed.
Yet, Utah physicians insist there is no rational explanation for the differences in payment from state to state, especially when great discrepancies in payment occur within the same geographic regions - such as the Mountain West.
"Our research indicates that the actual costs of practice, including such items as malpractice insurance, employee expenses, office rent, and supplies, are not substantially lower in Utah," Middleton wrote to Utah lawmakers. "In many cases the costs are higher in Utah than in our surrounding states."
Middleton said these discrepancies have led to several problems for Utah physicians. In fact, with federal laws holding their charges at "unreasonable" levels, some physicians have been unable to remain in practice. Six Utah neurosurgeons have closed shop - "at a time when more are needed." Even LDS Hospital has had difficulties in providing continuous neurosurgical coverage for trauma patients due to the shortage.
According to the physician/president, unrealistic Medicare fees have had their greatest impact on primary care physicians in Utah, who are under great pressure by the local Medicare carrier - Blue Cross and Blue Shield of Utah - to become "participating physicians."
Comments
- Y. scientists rip lawmakers on climate 3:21 p.m.
- Nature's Sunshine lawsuit settled 3:19 p.m.
- Hall, Cougars crush Cowboys 2:57 p.m.
- Pitt beats Syracuse 37-10 2:43 p.m.
- No. 24 Wisconsin holds off Indiana 2:41 p.m.
- Shipley's record day leads Texas 2:39 p.m.
- No. 16 Miami rolls past Virginia 2:36 p.m.
- Northwestern upsets Iowa 17-10 2:34 p.m.
- Family, friends remember nephew 1:54 p.m.
- Online math adds up to a lot of fun 11:57 a.m.
- Report details Prop 8 aftermath
410 - Gay advocates trek to LDS office
201 - Dirk does dirty work in Dallas
190 - Letters: Care not a right
184 - Lobo suspended
169 - Speed has never been BYU's game
136 - Jazz stumble in fourth quarter
106 - RSL rallies to advance
102 - Prep football: San Juan vs. S. Sevier
100 - Thousands protest health bill
98
Why do so many people live so close to refineries in Utah and elsewhere?
NASA's Stardust probe continues to bring new knowledge about the nature...
park city is going to win state were u even watching wasatch or delta? WE...
BYU doing what they do best, beating the average teams in the conference by a...
Dude, national championship? Hall for Heisman? What color is the sky in your...
Isn't that like the 7th time the Uties have predicted a BYU loss this year...
Like 11 intercetions will get Hall the Heisman. Gh please!!
Fact of the matter is BYU skunked Wyo on the road while Utah needed last...
Man o man! These cougars definitely keep us guessing, don't they? Who are...
I wonder if the Lobos will make tackles by punching people in the back, or...
come on hunter beat davis, so we can blow you out in the title game.
In Genesis God creates the world, the first man, and the first woman, and...


You can be the first to comment on this story.