National: Congressmen Introduce Medicare Payment Fairness Act

Representatives Keith Ellison (D-MN) and Tim Walz (D-MN) have introduced legislation to reform the Medicare fee-for-service practice. The Medicare Payment Fairness Act of 2009 (H.R. 3074) changes the Medicare payment structure by adding a value index. The bill has been referred to the Committee on Energy and Commerce.





Currently, Medicare reimburses on the basis of number of procedures completed and number of patients handled, which Rep. Ellison says often leads to unnecessary medical services. The proposed reforms in the bill change incentives in Medicare by rewarding regions based on a quality to cost ratio. There would be a value index of each fee schedule area and hospital service area. The value index would be a ratio of a quality component (a composite score reflecting quality measures available on a State or fee schedule/hospital service area basis. The measures would compare health outcomes and status for the Medicare population, (patient safety and patient satisfaction) to the cost component (ratio of the cost per beneficiary for such area to the national average cost per beneficiary).

"Minnesota is a national leader in providing high quality health care at a lower overall cost," Rep. Ellison stated in a press release on his web site. "Meaningful health care reform requires fundamental changes in how our country pays for health care and I believe that the nation can learn from Minnesota as we tackle health care reform."


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