[Congressional Record (Bound Edition), Volume 149 (2003), Part 3]
[Senate]
[Page 4026]
[From the U.S. Government Publishing Office, www.gpo.gov]




     THE MEDICARE INCENTIVE PAYMENT PROGRAM IMPROVEMENT ACT OF 2003

  Mr. THOMAS. Madam President, I am pleased to introduce S. 379, the 
Medicare Incentive Payment Program Improvement Act of 2003, with my 
distinguished colleague, Senator Bingaman. This legislation makes 
important improvements to the current Medicare Incentive Payment (MIP) 
Program. These refinements will go a long way in ensuring eligible 
rural physicians receive the Medicare bonus payment to which they are 
entitled.
  The Medicare Incentive Payment Program was created in 1987 under the 
Omnibus Budget Reconciliation Act to serve as an incentive tool to 
recruit physicians to practice in Health Professional Shortage Areas 
(HPSAs) by providing a 10 percent Medicare bonus payment. There are 
approximately 2,800 federally designated HPSA's--75 percent of which 
are located in rural areas. In my State of Wyoming, over half of the 
counties are designated as a Health Professional Shortage Area and have 
a difficult time recruiting physicians.
  Unfortunately, this well-intended program has not worked well due to 
the burden if places on providers. Under the current MIP programmatic 
structure, physicians are required to determine if the patient 
encounter occurred in designated underserved areas, they must attach a 
code modifier to the billing claim and must undergo a stringent audit. 
Additionally, there is evidence that many physicians who would be 
eligible are not even aware of the program.
  The legislation we are introducing today alleviates the 
administrative burden on rural physicians by requiring Medicare 
carriers to determine eligibility. The Medicare Incentive Payment 
Program Improvement Act of 2003 also requires the Centers for Medicare 
and Medicaid Services to establish a MIP education program for 
providers and establishes ongoing analysis of the MIP program's ability 
to improve access to physician services for Medicare beneficiaries.
  All physicians are struggling with last year's Medicare payment 
reduction of 5.4 percent and with the possibility of another 4.4 
percent reduction on March 1 of this year. These payment cuts combined 
with an ever-increasing regulatory burden to participate in the 
Medicare program and escalating medical malpractice premiums have begun 
to impact senors' access to care. As rural providers tend to be 
disproportionately impacted by Medicare payment cuts, it has never been 
more important to ensure that the few rural physician incentive 
programs that exist have a positive effect on the stability of our 
rural health care delivery system. I strongly urge all my Senate 
colleagues interested in rural health to cosponsor the Medicare 
Incentive Payment Improvement Act of 2003

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