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Senate GOP Leadership Sends New Letter Urging Washington to Protect Medicare Advantage Seniors

MARCH 09, 2016

New Letter Adds to Overwhelming Bipartisan Outcry Against CMS’ Proposed Cuts to Medicare Advantage that would Harm Beneficiaries

Washington, D.C. – A new letter signed by Senate Republican leadership and members of the Finance Committee adds to the overwhelming bipartisan support among lawmakers for the more than 17 million beneficiaries who choose Medicare Advantage for high quality, affordable care.

The letter was signed by: Senate Majority Leader Mitch McConnell (R-KY), Senate Finance Committee Chairman Orrin Hatch (R-UT) and Senators Chuck Grassley (R-IA), Mike Crapo (R-ID), Pat Roberts (R-KS), John Cornyn (R-TX), John Thune (R-SD), Richard Burr (R-NC), Johnny Isakson (R-GA), Rob Portman (R-OH), Dan Coats (R-IN), Dean Heller (R-NV) and Tim Scott (R-SC). Read highlights from the letter below:

  • “We write to express our concerns with a number of proposed policy changes in the 2017 Advance Notice that would reduce funding for the Medicare Advantage program. We have serious concerns about the negative impact these proposals would have on the health care choices and benefits of Medicare Advantage enrollees.”
  • “Many beneficiaries choose to enroll in Medicare Advantage plans because they appreciate the care coordination, disease management programs, preventive care, and other services offered by these plans.”
  • “We are specifically concerned about the following three proposals.”
  • Employer Group Waiver Plans: Medicare Advantage retiree coverage delivers proven care coordination and disease management activities for 3.2 million retirees nationwide. The proposal to revise the payment and bidding model for Employer Group Waiver Plans would negatively impact the retiree coverage provided to beneficiaries who receive coverage through their employer.”
  • Risk Adjustment: While we appreciate efforts to improve the accuracy of the risk model for dually eligible beneficiaries, the proposed changes to the risk adjustment model could undermine plan efforts to improve beneficiary health through early detection and prevention of chronic conditions. Additionally, we would note that this is the third model update in recent years and the fifth consecutive year for changes in how the scores are calculated. Such frequent changes add unnecessary cost, complexity, and uncertainty to the program.”
  • Encounter Data: The proposed changes would increase the percentage of risk score calculations that are based on encounter data from 10 percent to 50 percent. This is problematic because the encounter data system currently has numerous unresolved operational and technical issues and fails to capture a reliable, comprehensive picture of beneficiary diagnoses.”
  • “Recognizing the serious threat these proposals pose to the health coverage of Medicare Advantage enrollees, we strongly recommend that you carefully consider the impact of these changes on Medicare beneficiaries and, instead, adopt policies to strengthen Medicare Advantage.”

A new analysis from Oliver Wyman found that CMS’ proposed changes would result in an estimated 0.5 to 3.9 percent cut on average to Medicare Advantage payments in 2017. “Such reductions, coupled with the reductions experienced in 2014 through 2016, could have a significant impact on the sustainability of Medicare Advantage Organization (MAO) program participation and the ability of MAOs to provide stable benefits and affordable premiums to their members,” the report states.

More than 370 members of Congress have signed letters urging Washington to protect Medicare Advantage. Rep. Guthrie and Rep Murphy spearheaded a letter signed by 308 members of the House of Representatives. A bipartisan letter in the Senate led by Sen. Chuck Schumer (D-NY) and Sen. Mike Crapo (R-ID) received 61 signatures.

Earlier than ever this year, AHIP’s Coalition for Medicare Choices (CMC) launched a digital advertising campaign and a coast-to-coast mobilization of its 2 million Medicare Advantage beneficiaries, who are contacting their elected representatives and urging Washington to protect their coverage from further cuts. Heading into the November election, seniors are making this a priority voting issue.

Final Medicare Advantage payment rates are expected to be announced by CMS on April 4, 2016. Seniors will see the impact of new payment changes in late October 2016, when they begin enrolling in their 2017 Medicare Advantage coverage.