Radiologists s are lobbying for passage of a state bill that would ease the tax burden on physicians in exchange for treating the elderly, poor and members of the military.

Hawaii Senate Bill 1035 would work to relieve a shortage of doctors by exempting them from paying the state’s general excise tax, or GET. The perk would go to physicians treating beneficiaries in Medicare, Medicaid and TRICARE, the Maui News reported March 11.

“Nationwide, most medical practices lose money caring for Medicaid patients and typically break even caring for Medicare patients,” Scott Grosskreutz, MD, a radiologist with the Hawaii Provider Shortage Crisis Task Force, told the publication. “The GET taxation of gross revenues, when providers are breaking even or losing revenue, causes many practices in our state to be fiscally insolvent, jeopardizing their ability to keep their doors open.”

The burden of the GET tax typically falls on private practice physicians, with those in nonprofit or hospital settings exempt. Hawaii is the only state that currently has such a levy on medical services, the report noted, while New Mexico charges a tax on general receipts.

The Aloha State currently faces a shortage of 776 physicians or 22% of the required workforce, according to the University of Hawaii. Radiologists such as Andrew Kayes, MD, hope lessening the tax burden will help make it more attractive for docs to operate there.

“It has gotten more and more difficult to practice medicine year after year,” said Kayes, with Maui Diagnostic Imaging, who has cared for patients on the island for 16 years. “Many private practice physicians and providers that I know are operating on smaller and smaller margins due to cuts in reimbursements and increases in expenses. And although my primary goal is excellent patient care, my partners and I can’t run a practice on (just) good intentions.” 

Read more on the proposal below.