Fwd: qotd: Bipartisan support of Medicare Advantage overpayments

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-------- Original Message --------
Subject: qotd: Bipartisan support of Medicare Advantage overpayments
Date: Wed, 19 Feb 2014 12:56:59 -0800
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



United States Senate
Letter
February 14, 2014
To: Ms. Marilyn Tavenner, Administrator, CMS
From: 40 Senators - 21 Republicans and 19 Democrats

Excerpts

We write to raise serious concerns about the Medicare Advantage (MA)
2015 rate notice and the impact further cuts may have on the millions of
individuals enrolled in the program. We are strongly committed to
preserving the high quality health plan choices and benefits that our
constituents receive through the MA program. Given the impact that
payment policies could have on our constituents, we ask that you
prioritize beneficiaries' experience and minimize disruption in
maintaining payment levels for 2015.

MA has been a great success and should remain a competitive choice for
our constituents. Unfortunately, continued regulatory changes that
affect the program's funding, year after year, create disruption and
confusion among beneficiaries who are looking for consistency and
predictability.

While we are very supportive of your decision to assume a "doc fix" in
the 2014 MA rate calculation and urge you to continue it this year, the
MA program still experienced a real payment cut in 2014, not simply
reductions in rates of projected growth.

We urge you to maintain payment levels that will allow MA beneficiaries
to be protected from disruptive changes in 2015.

(Signatures of 40 Senators - click link to see names)

http://www.ahipcoverage.com/wp-content/uploads/2014/02/Bipartisan-Senate-MA-Letter-to-CMS-2015.pdf


Comment: AHIP, the health insurance lobby organization, has been
conducting an intensive campaign to prevent the reductions in
overpayments to the private Medicare Advantage plans - reductions
required by the Affordable Care Act. A hint at how successful their
campaign has been can be inferred from the fact that this letter from 40
senators, calling for perpetuation of the overpayments, but using AHIP
rhetoric, was downloaded from the AHIP website.

If you read the entire letter you will see that it is filled with AHIP
marketing phraseology touting the Medicare Advantage plans - distorting
the benefits of these private plans. Democrats can't blame Republicans
for this one. Democratic politicians are very much a part of this
conspiracy.

Last year the scheduled reductions were countered by increasing quality
rewards to MA plans that had not earned them. This year, the reductions
were partially countered by an accounting gimmick assuming a "doc fix"
to scheduled reductions in Medicare payments, even though no such fix
has been enacted. AHIP wants these "doc fix" increases to continue.

In a press release, AHIP President and CEO Karen Ignagni said, "CMS
should protect seniors in the program by maintaining current payment
levels next year," even though there is no basis for them. Private
insurers have promised lower costs, they have claimed lower costs, yet
their costs are higher than for comparable patients in the traditional
program.

Why should we care? The most obvious reason is that it is our tax funds
that are being given to these private health plans, paying them more
than it costs us to provide care in the traditional Medicare program. A
much more important reason is that enrollment in these plans continues
to expand, opening the door to converting Medicare into a "premium
support" program (vouchers) for a market of private plans. Traditional
Medicare will then be allowed to wither as an underfunded welfare
program, and perhaps eventually be abolished. Then the value of the
premium support vouchers will be allowed to diminish, shifting more
health care costs to the beneficiaries.

If these 40 senators really cared about their Medicare beneficiaries,
instead of asking CMS to overpay the private insurers, they would pass
legislation to increase coverage for those in the traditional Medicare
program in order to protect them from excessive out-of-pocket costs that
currently require medigap or employee retiree health benefit coverage.
Why should those in the private plans receive greater benefits when
we're all paying for them?

For single payer supporters who like to use the "Improved Medicare for
All" designation, it is imperative that the traditional Medicare program
be protected so that the public can understand that it is nominally a
framework on which single payer improvements can be built.

For the time being, instead of Congress insisting on paying more to the
private MA plans, we should demand that they move those overpayments to
the traditional Medicare program where they'll be put to better use in
reducing financial hardship, rather than giving them to the private
insurers to squander on gym memberships or whatever else might be used
to market their plans.