Senator Questions CMS Following Leak About MA Plan Payments
On Thursday, Sen. Chuck Grassley (R-Iowa) sent a letter demanding information from CMS about how a Wall Street analyst learned of the agency's decision to forgo a proposed payment cut to Medicare Advantage plans before it was officially announced, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 4/4).
In February, CMS proposed a 2.2% payment cut to MA plans in 2014. Lawmakers and health care stakeholders immediately criticized the proposal, saying it would result in benefit cuts or premium increases.
On April 2, CMS reversed course, changing the 2.2% cut to a 3.3% increase, after factoring in the assumption that Congress will prevent a 25% cut to Medicare physician reimbursements that is scheduled to take effect next year (California Healthline, 4/2).
In his letter, Grassley noted that an analyst at Height Securities released information about CMS' decision about an hour before CMS made its announcement, which caused stocks among health insurers that market MA plans to increase by "as much as 6% between 3:42 p.m. and when the markets closed" (CQ HealthBeat, 4/4).
He wrote, "This raises questions regarding political intelligence brokers' abilities to gather information from CMS in order to predict market-moving events," adding that the incident reflected a larger pattern of government officials offering such firms "special access" to nonpublic financial data (Daly, Modern Healthcare, 4/4).
Grassley requested that CMS provide a timeline on how the decision was made -- including all the people who were informed in advance of the announcement and all the relevant communications -- by April 9, the same day acting CMS Administrator Marilyn Tavenner is scheduled to appear in front of the Senate Finance Committee for her confirmation hearing ("Healthwatch, The Hill, 4/4).
CMS Defends 'Doc Fix' Assumption
In related news, CMS spokesperson Brian Cook recently defended the agency's assumption that Congress would enact a "doc fix," which some observers have criticized, Modern Healthcare reports.
In an email, Cook wrote, "Given consistent congressional action for over the past decade, [CMS] is exercising authority to reflect our best estimate of Medicare spending in 2014," adding that the situation was a "specific, unique circumstance" (Modern Healthcare, 4/4).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.