Under the budget agreement signed by President Bush, Medicare will still pay physicians for administering the routine electrocardiogram.

He proposed instead paying physicians on a salaried basis.

It will also look at new rate-setting strategy for paying physicians and at ways to improve access to health care.

However, the report added, "New York fails its needy population primarily by paying physicians at such absurdly low rates that few will treat Medicaid patients."

The same is true for millions of people who apply for Medicare reimbursement after they pay physicians and other medical providers.

Recent proposed changes to the Medicare fee schedule that would pay physicians more for talking, listening and thinking are a step in the right direction.

Dr. Roper, 41 years old, is an architect of a new policy for paying physicians under the Medicare health insurance program for the elderly.

Medicaid, the joint Federal-state program for 27 million low-income Americans, pays physicians, on average, just 69 percent of what Medicare does.

For decades, they had been paying physicians according to what were called "usual, customary, and reasonable fees."

The SGR determines how much money Medicare will pay physicians and other health care providers for health services.