[Congressional Record Volume 145, Number 112 (Tuesday, August 3, 1999)]
[Senate]
[Pages S10119-S10120]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. MURKOWSKI (for himself, Mr. Stevens, Mr. Inouye, and Mr. 
        Akaka):
  S. 1476. A bill to amend title XVIII of the Social Security Act to 
provide an increase in payments for physician services provided in 
health professional shortage areas in Alaska and Hawaii; to the 
Committee on Finance.


           health professional shortage in alaska and hawaii

  Mr. MURKOWSKI: Mr. President, I rise today to introduce legislation 
co-sponsored by my colleagues Senator Stevens, Senator Akaka, and 
Senator Inouye which will help to alleviate some of the financial 
hardships that currently face physicians who practice in remote areas 
of Alaska and Hawaii.
  Access to health care is the over-riding problem for Alaska's 
elderly. Almost weekly, I receive letters from seniors in Alaska who 
tell me that their doctor is no longer willing to accept Medicare 
patients. Why? Because doctors in rural areas lose money on Medicare 
patients.
  In a 1987 report to Congress, the Physician Payment Review Commission 
recognized that low Medicare payments in rural areas affect physicians' 
willingness to see Medicare beneficiaries.

[[Page S10120]]

In response, Congress provided a 10 percent bonus payment for all 
physician services provided in rural areas with the greatest degree of 
physician shortages. Unfortunately, reimbursement rates continue to be 
inadequate in Alaska and Hawaii where physicians must contend with 
extreme remoteness and high transportation costs. Alaska is currently 
70 percent medically underserved.
  The legislation which I am introducing today will increase the bonus 
payment for rural physicians in Alaska and Hawaii to 20 percent. By 
increasing these payments, physicians in Alaska and Hawaii will be 
better able to cover the additional costs which accompanies the 
delivery of health care in remote areas. Furthermore, this legislation 
will go far in helping Alaska and Hawaii retain current physician 
staffs and better meet the needs of Alaskan Native and Hawaiian Native 
communities.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1476

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. INCREASE IN PAYMENTS FOR PHYSICIAN SERVICES 
                   PROVIDED IN HEALTH PROFESSIONAL SHORTAGE AREAS 
                   IN ALASKA AND HAWAII.

       (a) In General.--Section 1833(m) of the Social Security Act 
     (42 U.S.C. 13951(m)) is amended by inserting ``(20 percent in 
     such an area in Alaska or Hawaii) after ``10 percent''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to physician services furnished on or after the 
     date of enactment of this Act.
                                 ______