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RCC 112

Para ordenar al Instituto de Estadísticas de Puerto Rico realizar un estudio sobre el costo de la práctica médica en Puerto Rico con el fin de proveer datos que justifiquen ante los Centros de Servicios de Medicare y Medicaid (CMS) la necesidad de un ajuste en los pagos a los proveedores de salud bajo el Medicare Fee Schedule; y otros fines relacionados.

2025-2028 Session

Puerto Rico orders statistical institute to document medical practice costs for Medicare rate adjustment advocacy to CMS.

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Bill Summary · RCC 112

Legislative bill overview

Bill RCC 112 mandates Puerto Rico's Institute of Statistics to conduct a comprehensive study on the costs of medical practice in Puerto Rico. The study's findings would be used to present evidence-based arguments to the Centers for Medicare & Medicaid Services (CMS) for adjusting Medicare reimbursement rates paid to healthcare providers on the island.

Why this is important

Puerto Rico's healthcare providers receive significantly lower Medicare reimbursement rates compared to mainland U.S. providers, despite similar or higher operational costs. This study could provide the empirical foundation necessary to advocate for rate adjustments that would improve provider sustainability and potentially expand access to healthcare services in Puerto Rico.

Potential points of contention

  • Data collection scope and methodology: Disagreement may arise over which medical specialties, facilities, and cost categories should be included to ensure the study comprehensively reflects actual practice costs without inflating claims.
  • CMS receptiveness: Even with robust data, CMS may resist rate increases due to budget constraints or policy priorities, limiting the practical utility of the study's findings.
  • Implementation timeline and costs: The bill does not specify funding, timeline, or resource allocation for the statistical institute, raising questions about feasibility and whether other priorities will be displaced.

Compiled from official sources — confirm details with the bill’s official record.

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