Close Close

Life Health > Health Insurance > Medicare Planning

Medicare Advantage Rate Fight Brews

Your article was successfully shared with the contacts you provided.


Medicare Advantage program supporters in Congress are gearing up to fight for an increase in the newly proposed 2010 reimbursement rates.

The Centers for Medicare and Medicaid Services announced Monday that the 2010 rates will be 0.8% greater than the 2009 rates.

The proposed increase is higher than the 0.5% increase CMS officials suggested in a preliminary projection released in February, but it is lower than the 4.24% 2009 increase and the 5.71% 2008 increase.

The 0.8% increase proposal is based partly on implementation of a 21% cut in 2010 physician reimbursement rates. Congress is expected to nullify the physician rate cut before it goes into effect, according to Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, Washington.

If the physician rate cut is implemented, the Medicare Advantage provider reimbursement total could drop about 5%.

AHIP says the cuts could lead to higher premiums and benefits reductions for the 11 million Medicare beneficiaries enrolled in Medicare Advantage plans.

“It’s an unnecessary disruption in the health security of seniors on Medicare Advantage,” Zirkelbach says.

Medicare Advantage providers must submit bids for 2010 plans in June, but Congress likely will step in before then, Zirkelbach says.

The Senate version of the budget resolution approved Thursday includes a provision asking CMS officials to approve final reimbursement rates based on the expectation that Congress will not allow the 21% cut to be implemented.

Sen. Max Baucus, D- Mont., chairman of the Senate Finance Committee, and Sen. Charles Grassley, R-Iowa, the highest ranking Republican on the committee, followed up Friday, by sending a letter to CMS that makes the same request.

“Congress does not intend to ignore the problems in the physician fee schedule, nor does it intend for these consequences to Medicare Advantage to take place,” Baucus and Grassley write in the letter.

The Senate version of the budget resolution still must be reconciled with the House version.

The budget resolution does not appropriate cash, but the final version of the resolution will help shape debate on bills that affect the budget.