CMS Approves 143 New Medicare Advantage Plans
CMS on Thursday announced the approvals of 143 new Medicare Advantage plans for 2005, CQ HealthBeat reports. The approvals will provide Medicare beneficiaries in 49 states with access to 428 health plans -- 41 of which are new to the program and 66 of which are new local PPOs. CMS said that about 90 current Medicare Advantage plans will increase their service areas this year. As a result of the approvals, 73% of Medicare beneficiaries in 2005 will have access to HMOs, 52% will have access to PPOs and 80% will have access to private fee-for-service plans, according to CMS.
Most Medicare beneficiaries in rural areas in 2005 will have access to private fee-for-service plans, and almost 20% of those beneficiaries will have access to HMOs, PPOs and other coordinated health plans for the first time, CMS said. HHS Secretary Mike Leavitt said in a news release, "We have created a market for plans to compete in providing the best deal for seniors. Now it is our responsibility to make sure seniors get the information they need to take advantage of these plans" (CQ HealthBeat , 6/30).
In related news, House Energy and Commerce Committee Chair Joe Barton (R-Texas) on Thursday said that CMS must close a "loophole" under which Medicare often overpays for prescription drugs dispensed in hospitals.
According to a recent Government Accountability Office report, Medicare pays 20% more than the hospital purchase price for 13 medications. Barton said, "In the worst case, GAO found the government is paying hospitals $79.04 for a dose of paclitaxel ... when doctors are paid $18.76 for administering the same dose" (CQ HealthBeat , 6/30).