MINNEAPOLIS, March 14, 2008—Senator Charles Grassley, R-Iowa, today introduced the Medicare Rural Health Access Improvement Act of 2008. The bill contains several physician payment provisions, including provisions to revise the work and practice expense geographic practice cost indexes (GPCIs).

One provision would extend the 1.0 work floor through 2009 and then eliminate the work GPCI adjustment in 2010.

Another provision would establish a practice expense floor of 1.0 for 2009 and reduce the practice expense GPCI adjustment by 50 percent in 2010 and beyond.

The bill also continues the five percent bonus incentive payments for physicians practicing in scarcity areas through 2009 and extends the payment arrangements for independent labs to bill Medicare directly for physician pathology services.

Grassley's statement of introduction described the problems experienced by "tweener" hospitals, too large to be Critical Access Hospitals, but too small to be financially viable under the Medicare hospital prospective payment systems.

The bill contains provisions for improving Medicare payments for both Medicare Dependent Hospitals and Sole Community Hospitals under the Medicare program. This includes improvements to the payment methodologies so that inpatient payments to these facilities would better reflect the costs they incur in providing care.

Text of Grassley statement