Legislation introduced by Del. Frederick C. Rummage (D-Prince George's) that would benefit a podiatrist who is a key political supporter received a lukewarm reception today, even though the bill was heard by the House Economic Matters Committee that Rummage himself chairs.
Dr. Paul Kay, a Prince George's County podiatrist who has been host to three fund-raisers for Rummage at his Anne Arundel County home, sought the legislation to force Blue Cross and Blue Shield of the District of Columbia, which has jurisdiction over the Maryland suburbs, to increase the amount it pays podiatrists for some surgical procedures.
Kay told the committee that Blue Cross and Blue Shield's current reimbursement policies for the so-called "minimum incision" procedure he employs discourage the use of what he said was an easier, less painful and less costly method of correcting bunions and other foot problems than traditional "open surgery."
But the legislation was opposed by a wide variety of groups, including the state podiatry association and the Maryland Health Insurance Association, and Rummage was privately criticized by some committee members for attempting to reward a friend and political supporter.
"He's crazy to do something like that," said one committee member. "Everybody puts in bills for their constituents, but this is so blatant it's shocking. Things like that make every member of the House look bad."
Rummage himself defended his bill, saying "I really take exception to the suggestion that I can't put a bill in to end a discriminatory practice just because he [Dr. Kay] is a friend of mine. Everyone has a right to be heard."
At issue in the legislation sought by Kay is the amount health insurance companies will reimburse podiatrists for repeat surgical procedures to remove bunions and perform other corrections. Blue Cross and Blue Shield of D.C. currently pays $275 for the first procedure, $137.50 for the second through fourth and $27.50 for the fifth through 10th.
Kay, waving the tools of his trade before the committee today, charged that Blue Cross and Blue Shield of D.C. pays less than 50 other insurers, including its sister corporation in Maryland, which pays $137.50 for the fifth through 10th procedures. Kay also said that the D.C. insurer pays less for the minimum incision procedure he performs with a small drill than it does for more time-consuming and expensive traditional surgery involving a hammer and chisel.
A Blue Cross spokesmen said reimbursement is the same for both procedures.
The legislation, as drafted, would only require all insurers to pay the same amounts for both methods of surgery. However, Kay, in his testimony, suggested he wanted a bill that would make the company pay what other insurers do.
In a letter to Kay last August, Blue Cross and Blue Shield of Washington estimated that the reimbursement change would cost $661 more for every patient requiring 10 procedures, resulting in a total cost of $1,500 for about 30 minutes of work by the doctor.
"We find it extremely difficult to believe that anyone could justify a reimbursment for 30 minutes of 'closed' surgical work exceeding $1,500," the letter said.
Rummage, who has aspirations to become the next speaker of the Maryland House, held a series of fund-raisers last summer and fall at Kay's home with representatives of the banking, insurance and real estate industries.