MEDICARE+CHOICE: ‘Mid-Course Correction’ Plea Denied
The managed care industry has met with "little enthusiasm" from Clinton administration officials in their request for "mid-course corrections" to ensure their continued participation in Medicare+Choice, CongressDaily reports. Last week, American Association of Health Plans President Karen Ignagi wrote to the Health Care Financing Administration expressing concerns about recent problems plaguing Medicare HMOs that have caused some plans to exit certain Medicare markets. She requested that plans be allowed to refile their rate proposals for 1999, which were originally filed in May before current health care spending trends were evident. However, HCFA Administrator Nancy-Ann Min DeParle said that "allowing all 900 plans to potentially refile 'would require an administrative effort that would be impossible to mount in the near term.'" During a Tuesday briefing, DeParle noted that while she remains "sympathetic to the plight" of many plans, she said "it is hard to see how allowing a large number of plans to presumably raise costs and decrease benefits" would aid Medicare recipients. However, DeParle "left open the possibility a small number of plans might be able to refile." Pete Stark (D-CA), the House Ways and Means Health Subcommittee ranking member and co-author of the recent Medicare regulations was even less sympathetic, CongressDaily reports. Stark said that he was skeptical all along that managed care plans could turn a profit and provide quality care to Medicare beneficiaries. "They're blaming it all on us, not recognizing that it's their own inefficiency and their own greed that's making the plans fail," he stated. As health plans threaten to pull out of the market, Stark asserted, "'Let 'em go home' if they cannot compete.'" However, DeParle cautioned against turning a blind eye to the plans' concerns, asking, "If they make decisions to pull out, does that undermine the confidence of our beneficiaries, who are already risk adverse?" (Rovner, CongressDaily, 9/30).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.