[Congressional Record (Bound Edition), Volume 157 (2011), Part 4]
[Extensions of Remarks]
[Page 4760]
[From the U.S. Government Publishing Office, www.gpo.gov]




   MEDICARE PHYSICIAN PAYMENT TRANSPARENCY AND ASSESSMENT ACT OF 2011

                                 ______
                                 

                           HON. JIM McDERMOTT

                             of washington

                    in the house of representatives

                       Wednesday, March 30, 2011

  Mr. McDERMOTT. Mr. Speaker, the Affordable Care Act includes key 
provisions to increase availability of primary care doctors. For 
example, it will pay a 10 percent Medicare bonus, expand loan 
forgiveness programs and create flexibility within the National Health 
Service Corps. However, an underlying persistent problem exists in 
Medicare that must be corrected if we are to make primary care 
sustainable.
  No single factor is driving the workforce crisis in medicine more 
than the income gap between certain procedure-heavy specialists and 
primary care/cognitive specialists. Last October the Wall Street 
Journal published an expose of the American Medical Association's 
Specialty Society Relative Value Scale Update Committee, also known as 
the ``RUC''.
  For two decades the RUV, a specialist-dominated panel, has encouraged 
national health care reimbursement policies that financially undervalue 
the essential and complex work of primary care providers and cognitive 
specialists, while favoring sometimes unnecessarily complex, costly and 
excessive specialty medical services. This imbalance drives results 
down for patients and drives medical costs even higher.
  The RUC's votes are not open to the public, yet Medicare has mostly 
rubber-stamped the RUC's recommendations over 90 percent of the time. 
Since the creation of the RUC in 1991, the income disparity between 
primary care versus procedure-heavy specialists has exploded.
  Today, I'm introducing a bill called the, ``Medicare Physician 
Payment Transparency and Assessment Act of 2011'' that will put a 
transparent light on the way CMS identifies and values health care 
services. My bill would add public and transparent data collected from 
independent analysts to compare to the RUC's recommendations. It would 
also use independent analytic contractors to conduct surveys and 
collect data for physician services paid under Medicare and to annually 
identify services that may be over or under-valued.
  I am proud to note that this bill is endorsed by the American Academy 
of Family Physicians and the Society of General Internal Medicine.
  It's time we let taxpayers, the citizens who pay the bills for 
Medicare, see for themselves how Medicare decides how much to pay 
doctors and for what.

                          ____________________