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Democrats Ask HHS To Limit Medicare Advantage Changes

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WASHINGTON BUREAU — Congressional Democrats who voted for big cuts in Medicare Advantage spending now are asking regulators to keep the cuts from affecting MA rates and benefits.

The leaders of the House and Senate committees who oversaw development of the Affordable Care Act – the legislative package that includes the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act, today told U.S. Health and Human Services Secretary Kathleen Sebelius to protect seniors against MA rate hikes and out-of-pocket costs increases in 2011.

The 2011 MA carrier bids are due Monday.

“The Affordable Care Act increases the authority vested in the secretary to hold MA plans accountable for their bid submissions,” the Democratic lawmakers write in their letter.

“Using this authority, we expect the secretary and officials at CMS to ensure that the bid proposals are accurate, merit approval and are not discriminatory in benefit design or relative to plan payments,” the lawmakers write.

Private insurance companies should justify any proposed changes in MA premiums or benefits, and Sebelius should use ACA provisions to protect seniors against MA plans that offer discriminatory benefit packages, the lawmakers add.

ACA provisions now limit the ability of MA plans to charge higher cost-sharing than fee-for-service Medicare in 3 specific categories, and the lawmakers say the provisions give Sebelius the authority to extend this protection to additional services.

The signers of the letter are Rep. Sander Levin, D-Mich.; Rep. Henry Waxman, D-Calif.; Sen. Max Baucus, D-Mont.; Rep. Pete Stark, D-Calif; Sen. John Rockefeller IV, D-W.Va.; and Rep. Frank Pallone Jr., D-N.J.

“Health care reform strengthened Medicare and made Medicare Advantage more competitive, but it is critical that we don’t let private insurance companies use these changes as an excuse to raise premiums or cut benefits for seniors to bolster their own bottom line,” Baucus, chairman of Senate Finance Committee, says in a statement announcing the letter.

ACA provisions call for the federal government to reduce payments to MA plans by about $136 billion over the next 10 years, according to the Congressional Budget Office.

The cuts would start in 2012, and the 2011 payment levels would stay the same as in 2010, according to a representative of the Centers for Medicare and Medicaid Services, the HHS agency that oversees Medicare.

America’s Health Insurance Plans, Washington, is blasting letter.

“Washington can’t slash $200 billion out of Medicare Advantage and then try to shift the blame to the health plans that administer the program when those cuts inevitably result in higher premiums and benefit reductions for seniors,” AHIP spokesman Robert Zirkelbach says. “The CBO has stated that additional benefits provided by Medicare Advantage will be cut in half and that millions of seniors will lose their current coverage.”

The CMS representative notes that CMS believes the MA cuts amount to $136 billion over the 2012-2020 period, not $200 billion.


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