Medicare payments for anesthesia services are possibly misvalued or undervalued, say 16 U.S. senators who are urging Health and Human Services Secretary Kathleen Sebelius to review the system Medicare uses to calculate payment rates for anesthesiologists.

"We write to express our concern that anesthesiology suffers from a payment disparity under Medicare," say the lawmakers in a letter dated Aug. 23.

The senators point to a July 2007 Government Accountability Office report that found Medicare payments for anesthesia services performed in 41 facilities were only 33% of commercial payor rates for the same services. In contrast, the Medicare Payment Advisory Commission reports that Medicare typically pays about 80% of commercial rates for other physician services.

"We believe the unique level of the disparity known as the '33% problem' warrants consideration of the anesthesia payments as 'mis-valued,'" write the senators. They urge Ms. Sebelius to involve experts in anesthesiology and payment methodologies in a review of the links between the anesthesia payment system and the Resource-based Relative Value Scale, which is used to calculate payments for other physician services.

The senators' letter follows on the heels of a similar letter 75 members of the House of Representatives signed in June.

Irene Tsikitas

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