CMS Officials Discuss Benefits of Private Medicare Advantage Fee-for-Service Plans in Advance of House Committee Hearing, CQ HealthBeat Reports
CMS officials on Monday held a press briefing to provide information about private Medicare Advantage fee-for-service plans in advance of a House Ways and Means Health Subcommittee hearing on the plans scheduled for Tuesday, CongressDaily reports. The Congressional Budget Office has reported that MA fee-for-service plans receive some of the largest overpayments among MA plans, and subcommittee Chair Pete Stark (D-Calif.) has said that lawmakers could use reductions in reimbursements to the plans to finance an expansion of SCHIP.At the briefing, acting CMS Administrator Leslie Norwalk and agency Center for Beneficiary Choices Director Abby Block released data that indicate reductions in reimbursements to MA plans would result in a loss of reimbursements for most counties nationwide (Johnson, CongressDaily, 5/21). The data also indicate that 59% of Medicare beneficiaries in rural areas who are enrolled in MA plans have fee-for-service plans, in part because other MA plans often are unavailable in those areas.
Norwalk and Block said that MA fee-for-service plans also benefit employers because they allow them to enroll retirees in a single nationwide plan. Norwalk and Block added that MA fee-for-service plans have cost advantages over traditional Medicare. For example, 77% of MA fee-for-service plans provide unlimited coverage for inpatient care, and 68% require Medicare beneficiaries to pay $1,000 or less for a 90-day hospital stay, they said (Reichard, CQ HealthBeat, 5/21).
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Norwalk said, "I have no doubt that Medicare Advantage is likely to look different after this year because of all the work that they need to do on other parts of the Medicare program and the SCHIP reauthorization. So, given all that's going on, I would prefer that they make decisions based on the most current, up-to-date, fact-based set of circumstances as possible" (CongressDaily, 5/21).
Block said that CMS "will offer to work with" lawmakers to help decide where to target reductions in reimbursements to MA plans. Block added, "The beneficiary benefits enormously from being in any Medicare Advantage plan and even from being in a private fee-for-service plan" (CQ HealthBeat, 5/21).
