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Congressional members support geographic measure accuracy

The Wisconsin Medical Society (Society) and Iowa Medical Society (IMS) worked with a bipartisan group of lawmakers to encourage development of a more equitable way to determine the geographic measures used to calculate the Medicare reimbursement rate for physicians. In this letter, sent to Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt earlier this week, the group called on CMS to address Geographic Practice Cost Index (GPCI) data inaccuracies.

The effort was led by U.S. Sens. Tammy Baldwin, D-Madison, and Chuck Grassley, R-Iowa. Wisconsin’s U.S. Sen. Ron Johnson, R-Oshkosh, and U.S. Reps. Sean Duffy, R-Weston, Glenn Grothman, R-Campbellsport, Ron Kind, D-La Crosse, Gwen Moore, D-Milwaukee, Mark Pocan, D-Madison, and Reid Ribble, R-Sherwood, joined all the members of Iowa’s congressional delegation in signing on to the letter.

CMS uses inaccurate GPCI data in two areas to factor in differences in the various costs of a physician’s practice: physician work (PW) and practice expense (PE). Studies conducted on Medicare’s geographic adjusters acknowledge that GPCI measurements are inaccurate due to flawed methodologies, which cost Wisconsin physicians at least $10 million a year on the PW GPCI alone.

In the letter, Congressional leaders urge CMS to modify its measurements and provide transparency around its data inputs and weighting before publishing its proposal on the eighth GPCI update this summer. Specifically, the letter asks that CMS explain how it will accurately determine the regional cost of physician labor when establishing the PW GPCI and make the practice expense data and derivation of weighting and expense adjustments totally transparent.

The Society will continue to encourage CMS to address the GCPI issue after the proposed Medicare Physician Fee Schedule is released in July. If CMS takes no action to correct the methodology, the Society and IMS are prepared to work with their respective congressional delegations to introduce legislative language that would solve the GPCI inequity problem for their respective states.

For more information, e-mail Chris Rasch, the Society’s director of state and federal relations.

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