Lawmakers Step Up Criticisms of Proposed Cut to MA Payments
Lawmakers and health care stakeholders are stepping up their criticism of a proposed 2.2% cut in federal payments to Medicare Advantage plans and are urging the Obama administration to reconsider the proposal, The Hill's "Healthwatch" reports (Baker [1], "Healthwatch," The Hill, 3/28).
In February, CMS proposed several rules, including a 2.2% payment cut to MA plans in 2014. The changes would cut payments by about $11 billion, according to America's Health Insurance Plans.
On Thursday, AHIP released three separate letters in protest to the proposed payment reduction from:
- A bipartisan group of House lawmakers from New York;
- The entire Massachusetts House delegation; and
- A group of six House Democrats from various other states.
The House Democrats urged CMS to recalculate the proposed 2.2% cut to MA payments on the assumption that Congress will prevent a 27% cut to Medicare physician reimbursements that is scheduled to take effect next year. Congress routinely has blocked such payment cuts by issuing a temporary patch, known as a "doc fix." Lawmakers have been trying to address the sustainable growth rate, which sets the Medicare physician payment rates.
A Congressional Research Service report said CMS has the authority to assume another doc fix when it calculates MA payments (Baker [1], "Healthwatch," The Hill, 3/28).
AMA Renews Call for Permanent 'Doc Fix'
Meanwhile on Thursday, the American Medical Association pressed lawmakers to step up their efforts to block the next doc fix with a permanent fix to the SGR, "Healthwatch" reports. AMA echoed the recommendation by Congress' Medicare advisory board.
AMA said the controversy over the 2.2% cut in federal payments to MA plans raises the need for a permanent resolution to the SGR issue. The Congressional Budget Office has estimated that "the cost to repeal the SGR is now less than half the cost projected at this time last year -- Congress should act now, before this sale price ends," AMA noted.
The group added that the proposed MA plan cut is "another consequence of Congress' inaction to eliminate this failed formula and replace it with a system that works for patients and physicians" (Baker [2], "Healthwatch," The Hill, 3/28).
According to Reuters, the Obama administration is expected to issue final details about the payment reduction on Monday.
Reduction to Proposed Cut Could Boost Insurance Industry Shares
In related news, insurance industry shares also could be boosted if the level of the proposed payment cut to MA plans is reduced, Reuters reports. Industry observers say HHS might revise the proposed reduction to avoid the risk of insurers dropping certain coverage. Insurance companies have lobbied against the cuts for the past month through a television campaign aimed at MA beneficiaries (Humer, Reuters, 3/27). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.