[Congressional Record (Bound Edition), Volume 152 (2006), Part 18]
[Extensions of Remarks]
[Page 23793]
[From the U.S. Government Publishing Office, www.gpo.gov]




 PROPOSED RULE REGARDING THE MEDICARE PROGRAM AND REVISIONS TO PAYMENT 
                                POLICIES

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                           HON. LUIS FORTUNO

                             of puerto rico

                    in the house of representatives

                       Thursday, December 7, 2006

  Mr. FORTUNO. Mr. Speaker, I would like to express my concern over the 
proposed rule put forth earlier this year by the Department of Health 
and Human Services regarding the Medicare Program and revisions to 
payment policies under the physician fee schedule for calendar year 
2007. This rule, as written, would have a negative impact on Puerto 
Rican doctors and their patients. While I fully support the overall 
objective of the changes--to ensure that HHS payment systems are 
updated to reflect changes in medical practice and the relative value 
of services--I am confident that can be achieved without inflicting 
another harmful financial burden on Puerto Rico. I would support 
legislative activity that would prevent further cuts from taking place.
  First, it must be understood that the cost of living in Puerto Rico 
is at least the same, if not higher than in the U.S. mainland. As a 
matter of fact, the costs of transportation, water, electric power and 
housing are all notably higher on the Island. These cost differentials 
were not adequately considered in the proposed rule.
  Under the proposed rule, Puerto Rico would be forced to assume two 
large losses. The first is on the elimination of the payment floor with 
slightly over a 2 percent cut, plus the cuts in each of the 
specialties. Radiology would suffer the most, with an average cut of 16 
percent. This is an issue that affects doctors, patients and ultimately 
the quality of care that can be provided to those most in need. I 
strongly recommend that these proposed reductions be suspended for 
calendar year 2007, and that the impact of any further floor reductions 
be considered thoroughly before implementation.
  As you know, Puerto Ricans are U.S. citizens and pay the same 
Medicare payroll taxes and deductibles as their fellow citizens in the 
50 States. Thus, we must ensure that Medicare recipients in Puerto Rico 
have the same access to quality health care as those in the 50 States, 
and that health care providers on the Island receive satisfactory 
reimbursements for their services.

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