,,ii  #aacth ,,congress  #b;d ,session  
,s4 #bahf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ca1    
#bjad ,mr4 ,begich introduced the       
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to provide   
for a minimum ,medicare payment rate for
 primary care services furnished by     
primary care physicians4  #a4 ,short    
title  ,this ,act may be cited as the   
,medicare ,access ,improvement ,act of  
#bjad4  #b4 ,findings ,congress finds   
that the #bjaj ,report to ,congress of  
the ,interagency ,access to ,health     
,care ,in ,alaska ,task ,force found    
that-- 7#a7 there is a shortage of      
primary care ,medicare providers in     
,alaska1 a problem most severe in       
,anchorage but evident in ,fairbanks as 
well as in rural ,alaska2  7#b7 the main
 reason physicians give for not wanting 
to add new ,medicare patients is their  
perception of ,medicare's inadequate    

reimbursement2  7#c7 the ,medicare      
program has the lowest reimbursement    
level of the six primary payers of      
health care in ,alaska2  7#d7 the       
typical physician can have a viable     
practice in ,alaska without servicing   
any ,medicare patients2 and  7#e7 many  
in the provider community believe that a
 fair1 adequate1 and uniform ,federal   
rate would alleviate existing provider  
shortages in ,alaska4  #c4 ,minimum     
,medicare payment rate for primary care 
services furnished by primary care      
physicians ,section #ahdh7;b7 of the    
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;b77 is amended by adding at  
the end the following new paragraph3    
7#h7 ,minimum payment rate for primary  
care services furnished by primary care 
physicians  7,a7 ,in general            
,notwithstanding any other provision of 
this section1 subject to paragraphs     
7#c71 7#g71 and 7#h7 of subsection 7a7  
and subsection 7p71 the payment rate    
under the fee schedule under this       

section for primary care services 7as   
defined in subparagraph 7,b77 furnished 
in #bjae and #bjaf by a physician with a
 primary specialty designation of family
 medicine1 general internal medicine1 or
 geriatric medicine may not be less than
 #ajj percent of the payment rate that  
applied in #bjac to such services and   
such a physician under the ,medicaid    
plan under title ,,xix for the ,state in
 which the service is furnished4  7,b7  
,primary care services defined ,in      
subparagraph 7,a71 the term primary care
 services means evaluation and          
management services that are procedure  
codes for services in the category      
designated ,evaluation and ,management  
in the ,healthcare ,common ,procedure   
,coding ,system 7established by the     
,secretary under subsection 7c77#e7 as  
of ,december #ca1 #bjad1 and as         
subsequently modified74  4