Senator Boxer:  Access to Essential Health Care Services   

Thursday, October 16, 2008  

Dear Friend:

I recently wrote to the Centers for Medicare and Medicaid Services (CMS) to urge that it quickly implement a process to reimburse thousands of California physicians who have not received payments for Medicare claims since early in 2008.

The delay in payment of doctors for Medicare claims has potential impact for everyone.  Many doctors depend on these payments to maintain their medical practices, and in these tough economic times, some medical practices simply do not have the option of waiting for payment.

My letter is aimed not just at getting doctors paid for their services, but also at ensuring that the millions of Medicare beneficiaries across California continue to have access to essential health care services. 

October 6, 2008

Mr. Kerry Weems
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD  21244

Dear Mr. Weems:

I write to you today on behalf of the thousands of California physicians who have not received payment from Medicare since the spring of 2008.  I understand that these unprecedented delays were caused by difficulties in implementing the National Provider Identifier (NPI) system, which were exacerbated by the complications of transitioning California‚Äôs physicians to a new payment contractor.  I am writing to urge you to take immediate action to make advance payments to these physicians, and ask you to dedicate any additional resources necessary to resolve these outstanding cases.

The inability of Centers for Medicare and Medicaid Services (CMS) to facilitate advance payments to doctors affected by these delays or respond in a timely manner to physicians inquiring about the status of their payments has placed an enormous financial burden on these doctors through no fault of their own.  Although in the past physicians could overcome such a delay in payments through short term loans, the current economic instability makes this difficult if not impossible for many of these struggling practices. 

CMS should establish a simple process for physicians to get advance payments to help them pay their staffs and maintain their practices.  CMS must also be proactive in informing physicians about the availability of advances and how to get them.  In addition, CMS must commit additional staff and resources to resolving these outstanding cases.  Each impacted physician practice should be contacted by phone by your agency or contractor to review unresolved application issues. 

These delays have threatened the viability of thousands of medical practices across California, and may ultimately reduce the access to essential health care services for Medicare beneficiaries.  I thank you for your attention to this critical issue and look forward to your prompt response.


Barbara Boxer, US Senator, California
U.S. Senator Barbara Boxer