Medicare Advantage Funds Targeted for Other Programs
Democrats this year are making "concerted efforts" to cut Medicare Advantage payment rates "as a way to finance other spending priorities," such as fixing a scheduled 10% reduction in Medicare physician payments, CQ HealthBeat reports (Carey, CQ HealthBeat, 3/6).
House Energy and Commerce Health Subcommittee Chair Frank Pallone (D-N.J.) on Tuesday said he supports eliminating overpayments to Medicare Advantage plans to prevent the physician payment reduction scheduled to take effect next year (Johnson, CongressDaily, 3/7).
House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) cited data from a Medicare Payment Advisory Commission report that indicated payment rates to Medicare Advantage plans average 112% of fee-for-service payment rates (CQ HealthBeat, 3/6).
Stark and Pallone both have said they want to find a permanent solution for the Medicare physician payment system.
MedPAC Chair Glenn Hackbarth on Tuesday told the House Ways and Means Health Subcommittee that a permanent solution to the physician payment system could be funded in part by reimbursing Medicare Advantage plans at the same rate as traditional fee-for-service plans and by stopping inflation updates in payments to Medicare providers.
MedPAC also has recommended that the federal government develop payment incentives for physicians who provide quality care and eliminate overpayments of certain services.
Hackbarth said overpayments could be addressed by CMS at a regulatory level while other proposals, such as linking reimbursements with quality care measures, would require congressional action.
Stark also suggested that revenue generated by Medicare Advantage payment cuts could be used to expand SCHIP (CongressDaily, 3/7).
Separately, Senate Finance Committee Chair Max Baucus (D-Mont.) on Tuesday said Medicare Advantage cuts could help fund an expansion of SCHIP (CQ HealthBeat, 3/6).
According to CongressDaily, eliminating overpayments to Medicare Advantage plans would generate $60 billion over 10 years, nearly enough to expand SCHIP coverage to all eligible children -- which is estimated to cost $50 billion over five years -- but not enough to also address physician payments (CongressDaily, 3/7).
Rep. Jim McCrery (R-La.) on Tuesday in a letter to House colleagues wrote that cutting Medicare Advantage payments could affect low-income and minority beneficiaries. He said that Congress has "made that mistake before," noting that when lawmakers reduced Medicare Advantage plan payments in 1997, many plans dropped out of the program and more than two million beneficiaries lost access and benefits (CQ HealthBeat, 3/6).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.