Payment Increases to Medicare Advantage Plans Lower
CMS on Monday said that reimbursement rates for Medicare Advantage plans in 2007 will increase by only about 1.1% on average, rather than 4% as scheduled, because of a technical adjustment of how physicians code beneficiaries for billing, CQ HealthBeat reports. According to CQ HealthBeat, past small increases in reimbursement rates have led to decreases in benefits offered by Medicare Advantage plans.
Medicare Advantage plans in most cases offer more benefits than traditional Medicare because of higher reimbursement rate increases established under the 2003 Medicare law, in addition to separate subsidies from the federal government for plans that provide prescription drug coverage.
Karen Ignagni, president of America's Health Insurance Plans, said, "No member of Congress will be able to conclude that plans are overpaid next year."
CMS Administrator Mark McClellan said that enrollment in Medicare Advantage plans has increased by one million beneficiaries since January (Reichard, CQ HealthBeat, 4/3).
In other Medicare news, dialysis facilities in 2005 acquired the anemia medication darbeopoetin alfa at prices lower than Medicare reimbursement rates for the treatment, according to a study by the HHS Office of Inspector General, CQ HealthBeat reports. For the study, which was required under the 2003 Medicare law, researchers examined data from 46 dialysis facilities and found that their net acquisition costs for darbeopoetin alfa ranged from $2.24 per microgram to $2.94 per microgram in 2005, compared with Medicare reimbursement rates of between $3.01 per microgram and $3.54 per microgram.
According to the report, CMS can use the results of the study to establish 2007 Medicare reimbursement rates for darbeopoetin alfa (CQ HealthBeat, 4/3).