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No Doctor In the House: New Legislation Calls for Action to Create Medicare Clinics

JUNEAU - Feb. 10, 2020 - Today three Democratic legislators called for action to address a growing problem for Alaska's seniors. Many Alaska physicians won't provide medical care for seniors on Medicare. The effort is supported by AARP's Alaska chapter. "The problem's been the same, regardless of which party's been in charge in Washington," said Rep. Les Gara (D-Anchorage). "It's a major problem that requires action now, not later." Gara, has sponsored the Medicare and Primary Care Access Act with Reps. Sharon Cissna and Lindsey Holmes (both D-Anchorage).

"Too many seniors are losing access to their doctors. It's important that we work towards solutions to this problem, and this is part of the solution," Holmes said.

"So many seniors find themselves without access to primary care. Federal solutions seem far away, yet this bill brings action now on a serious local issue," Cissna, a longtime leader on health issues, said. 

A Federal Problem; a State Solution:
Medicare has under-compensated medical providers in Alaska for general office visits, or "primary care", for many years. According to an attached University of Alaska study, only 15 out of 75 surveyed Anchorage physicians would see new Medicare patients, and 20 would not accept Medicare under any conditions. Senator Mark Begich recently called for a vote on legislation he's co-sponsored. The legislation, S 1776, would solve this problem directly by increasing Medicare reimbursement rates in places like Alaska, where they are too low. A vote on that legislation was blocked this fall by Senate filibuster rules.

While states are currently precluded under federal law from increasing Medicare reimbursement rates, federal law does allow states an option - to help create Medicare clinics. It is one of the few state approaches allowed under Federal law. Clinics designated as "community health centers" are allowed, under federal law, to bill Medicare at a much higher rate, making treatment at those clinics cost-effective. HB 335 creates a grant fund to help spur the creation and expansion of Medicare clinics for patients who cannot find a medical provider to treat them.  

"AARP is in strong support of this effort to enable more Alaska older citizens to have access to a physician. The situation is critical in many communities and is getting worse every day," said Pat Luby, Advocacy Director of the Alaska Chapter of the AARP. Joan Fisher, who runs Anchorage's main community health center and has long-sought a solution to this problem, stated: "Medicare beneficiaries find themselves without a primary care physician at a time in their life when adequate care and access is critical. Community Health Centers play a vital role in serving Medicare patients and solving the primary care health services shortage throughout Alaska."

Currently at least two Medicare clinics are under discussion. Dr. George Rhyneer is trying to organize an effort to start an Anchorage clinic, and Providence Hospital has discussed the possibility on a clinic as well. It is hoped legislative help might move projects like these forward.

A prior legislative effort, HB 178, sought to make up for low Medicare reimbursement rates by granting medical providers a bonus for seeing significant numbers of Medicare patients. However, this summer federal officials stated it would likely violate the federal ban on supplemental Medicare payments.

For further information please contact the co-sponsors. Pat Luby can be reached at 762-3314, and Joan Fisher can be reached at 792-6528.

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