S.C.R. NO.














REQUESTING THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO consider raising the medicare fee schedule payment amounts fOR physicians rendering services in hawaii.




     WHEREAS, reimbursement levels for Medicare and Medicaid are based upon the Medicare fee schedule, which is constructed from the Medicare fee schedule payment amount formula; and


     WHEREAS, the fee schedule formula for each physician service is basically a conversion factor multiplied by relative value units; and


     WHEREAS, the conversion factor converts the relative value units into dollars, and the relative value units generally reflect the value of a particular physician service in relation to other physician services; and


     WHEREAS, the relative value units are composed of three components reflecting the concepts of physician work, practice expense, and malpractice expense; and


     WHEREAS, each of these three components of the relative  value units are multiplied by respective geographic practice cost indices so that the physician fee amount is geographically adjusted to the geographic region of the country in which the service is rendered; and


     WHEREAS, these geographic adjustments are generally done administratively by the federal Centers for Medicare and Medicaid Services; and


     WHEREAS, for the year 2009, the geographic practice cost indices for Hawaii in are 1.000, 1.161, and 0.665 for the indices related to physician work, practice expense, and malpractice expense respectively; and


     WHEREAS, the single geographic practice cost index of 1.000 for the physician work component represents the lowest possible value for that index, and undoubtedly has an adverse effect on the level of physician payments for services rendered in Hawaii; now, therefore,


     BE IT RESOLVED by the Senate of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2009, the House of Representatives concurring, that the Centers for Medicare and Medicaid Services is respectfully requested to recognize that the physician fee amounts for Hawaii that result from the numeric values of the geographic practice cost indices that the Centers for Medicare and Medicaid Services assign to Hawaii do not accurately reflect the payment levels that physicians rendering services in Hawaii should be receiving for those services and to increase the geographic practice cost indices for Hawaii; and


     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Acting Administrator of the Centers for Medicare and Medicaid Services, the members of Hawaii congressional delegation, the Governor, and the state Director of Health.









Report Title: 

Medicare Reimbursements