More Lawmakers Pile on Proposed Medicare Advantage Cuts

The Hill by Sam Baker –

March 28, 2013:

The federal Medicare agency on Thursday met more bipartisan resistance to its proposed cuts in Medicare Advantage payments.

Lawmakers have written to the agency in droves to protest the cuts — a 2.2 percent reduction in next year’s payments, on top of cuts included in President Obama’s healthcare law that have not yet taken effect.

America’s Health Insurance Plans (AHIP), the trade group representing insurance companies, released three more letters Thursday: a bipartisan plea from members of the New York delegation; a letter from the entire Massachusetts delegation; and a third letter from six House Democrats.

“Recognizing that the [Medicare Advantage] program serves as a health care safety net for more than 25 percent of the Medicare population, we believe it is critically important for Congress and the Administration to maintain a strong and stable (Medicare Advantage) program,” the Democrats wrote.

The lawmakers urged the Center for Medicare and Medicaid Services (CMS) to change the way it calculated the 2.2 percent cut.

The CMS assumed a 27 percent cut in Medicare’s payments to doctors will take effect next year, as scheduled. But Congress almost always blocks those cuts from taking place and is likely to do so again.

The lawmakers want the agency to assume another temporary fix preventing the cut to doctors from happening. That would also lead the agency to scale back its proposed cuts to Medicare Advantage, which are Medicare plans administered by private insurance companies.

The CMS has said it has to base its projections on the letter of the law, and the letter of the law calls for a 27 percent cut in doctors’ payments.

A new report from the Congressional Research Service, though, suggests that the CMS has the authority to assume another “doc fix” when calculating its Medicare Advantage payments.

The agency’s current interpretation is well within its legal authority, the CRS said, but the agency could probably also justify changing its mind.

Source: John & Rusty Report via Choice Admin