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AIS's Health Business Daily
Featured Story Sept. 10, 2009
Congress Returns from Recess with Direction of Medicare Advantage Pay Cuts Still Unclear Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and analysis on the Medicare (and Medicaid) managed care programs. By Judy Packer-Tursman, Editor, (tursman@comcast.net) Congress is returning to Capitol Hill facing the urgent need to address a myriad of unresolved issues on how to pay for an overhaul of the nation’s health care system — including how to accomplish Medicare Advantage (MA) payment reform. Recent national polls suggest that the proportion of seniors — 11 million of whom are enrolled in MA plans — supporting Democrats’ health reform proposals has slipped to about one-third. Republicans have jumped on seniors’ concerns. Republican National Committee Chairman Michael Steele asserted Aug. 24 that the GOP’s first priority under health reform is to protect seniors. Steele unveiled a “Seniors’ Health Care Bill of Rights” that, among other provisions, opposes the administration’s proposals to cut payments to MA plans and to turn the Medicare Payment Advisory Commission (MedPAC) into an executive branch agency and give it authority to decide and implement Medicare payment policies. Democrats, in turn, are accusing the GOP of raising seniors’ worries about possible rationing of care among other matters, and they are stressing that there is no intention of reducing Medicare benefits under a reformed system. “It’s pure political speculation. I think it’s very difficult to assess where we are,” attorney Bruce Merlin Fried, a partner in the Washington, D.C., office of the law firm Sonnenschein Nath & Rosenthal LLP and former head of HCFA’s managed care division, told MAN Aug. 31. At one point, Fried says, he thought that the Senate might be “less aggressive on MA” than the House. “Now I don’t have a clue,” he says. He cites many factors contributing to the political uncertainty, from Sen. Ted Kennedy’s death to federal lawmakers’ concerns after being confronted with an at-times-irate public reaction to Democratic reform proposals. There is the issue of how moderate House Democrats will react to what constituents tell them over the recess, he says, and a growing realization among millions of seniors that they stand to lose MA benefits. “I think in many cases it’s a lot easier to scare people than it is to educate them and get the facts to them,” AARP spokesman Jordan McNerney told MAN Aug. 31. He added that he is not implying that MA-related groups are involved in such scare tactics. AARP is “absolutely supportive of choice” for seniors, McNerney says. At the same time, he says the powerful lobbying group for seniors doesn’t think that MA plans ought to be costing the program more than does fee-for-service (FFS) Medicare coverage. He says AARP seeks to end overpayments to MA plans, either through competitive bidding or a gradual phase-down of MA plan payments to parity with FFS. And the group wants quality bonus payments to be incorporated into whatever MA payment reform strategy is chosen as an incentive for plans to improve themselves, he adds. Amid the political rhetoric, several reports have been recently released and circulated on the Hill, bolstering one side or the other in the ongoing debate over health reform in general and MA in particular. Among them:
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