REP. MIKE THOMPSON MEDICARE REIMBURSEMENT FIX PASSES COMMITTEE Fix Ensures Medical Professionals in Sonoma County Are Reimbursed at Appropriate and Up-to-Date Levels

U.S. Rep. Mike Thompson's (CA-5) helped lead an effort on Thursday to fix the out-dated formula used to determine Medicare reimbursement payments through the House Committee on Ways and Means. Currently, Medicare reimburses physicians according to the Geographic Practice Cost Index (GPCI), an index based on cost of living, cost of providing care, cost of malpractice insurance and other provider costs.

Counties in California are put into one of nine separate reimbursement localities based on the GPCI formula. Counties with similar GPCIs are supposed to be put in the same reimbursement locality. However, Sonoma County, which despite having a high cost of living, it is classified as a rural county. Because of this out-dated rural classification, physicians are being reimbursed at a level that doesn't accurately reflect the costs of providing care in that area. A legislative fix, advocated for by Thompson, was passed unanimously by the House Committee on Ways and Means to correct this by updating the outdated payment localities to the current Metropolitan Statistical Areas (MSAs), which is the same way Medicare currently pays hospitals.

"Medical professionals in Sonoma County who care for Medicare beneficiaries are not being reimbursed at the appropriate, up-to-date levels," said Thompson. "This fix will make sure Sonoma County's medical professionals get reimbursed at levels similar to those in neighboring, urban-classified counties. And, it will help protect and improve access to care."

"The California Medical Association sends a huge thanks to Congressman Mike Thompson for his strong leadership and advocacy on behalf of California physicians and their patients to enact Medicare reforms that will protect and improve access to care in Northern California," said Dr. Richard Thorp, President of the California Medical Association.

The fix advocated by Thompson was included in an amendment to H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 which was passed unanimously by the House Committee on Ways and Means on Thursday, December 12th, 2013. The amended version of H.R. 2810 will now be combined with a similar proposal considered by the House Committee on Energy and Commerce, and could go to the House floor for a vote as early as next month.


Congressman Mike Thompson is proud to represent California's 5th Congressional District, which includes all or part of Contra Costa, Lake, Napa, Solano and Sonoma Counties. He is a senior member of the House Ways and Means Committee and the House Permanent Select Committee on Intelligence. Rep. Thompson is also a member of the fiscally conservative Blue Dog Coalition and chairs the bipartisan, bicameral Congressional Wine Caucus.

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