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- Kristina on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Curt Black on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Margaret on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Jane Wall Medicare Health Benefits Inc on Strange Bedfellows Come to Medicare Advantage’s Rescue
- Barb Housewright on What Happens to Medicare/Medicaid If There’s a Government Shutdown?
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Topic: Part D
Drugs and Patient Safety – the Disconnect
The recent Washington Post piece published May 11, 2013, on the prescription drug dangers for Medicare patients raises some interesting points about the current prescribing habits of some outlier physicians/prescribers, as well as the lack of a coordinated effort to exclude those same prescribers from participating in Medicare.
Medicare Essential – Is this the future of Medicare?
According to The Hill’s Elise Viebeck President Obama is receptive to combining Medicare Part A (in-patient hospital) and Part B (outpatient and doctor) deductibles, into a single deductible just like every other insurance scheme in the US. Predictably those to his left complained, maybe because Virginia’s Eric Cantor also likes the idea. The impact would raise the deductible for people who use only physician services, lower it for anyone who is hospitalized, and, net, save Medicare money by shifting more costs to beneficiaries. However, some of the savings would also be used to add an annual out-of-pocket cap on what beneficiaries would have to spend. This is good insurance logic: don’t cover relatively low cost, predictable expenses. Focus coverage on protecting beneficiaries from catastrophic loss.
GHG’s Comments on 45-day notice
Click here to review GHG’s comments in response to the Advance Rate Notice, submitted to CMS on March 1, 2013.
Little Good News for Medicare Advantage in Senate Finance Hearing
The Senate Finance Committee held a hearing on Medicare yesterday and received testimony by CMS Medicare chief Jon Blum. Almost a week after the shocking 45-day Notice for Medicare Advantage (MA) and Part D was released, Blum offered little in the way of good news on the 2014 rates.
Draft Call Letter for 2014
The bad news in the 45 day notice is proposed payment cuts to Medicare Advantage plans for 2014 and big changes to risk adjustment but there is also good news about the reduction in almost all of the Part D benefit parameters. The draft Call Letter, which accompanied the proposed rate announcement, also included some news-worthy developments for MA and Part D plans. The document shows that CMS is actively using its regulatory and purchasing authority. CMS is planning to take action in several areas where oversight and monitoring have identified problems or where beneficiary complaints have been noted. In addition, CMS is signaling its intent to use MA plans as laboratories for achieving the Triple Aim.
CMS Advance Notice for 2014: This Is What Austerity Looks Like
CMS’s Advance Notice for Medicare Advantage and Part D for 2014 was released after the close on Friday and tanked health plan stocks on Tuesday. It is a shocking, stark portrait of what austerity looks like. There’s nothing but bad news in it, and it’s worse than anyone expected. Start with an average cut in payments of 6% (combined impact of ACA, proposed trend, and increase in coding adjustment); now add the likelihood of sequestration taking effect on March 1 — another 2% cut; add the impact of draconian changes in risk adjustment and the 2014 industry tax for another point or two. All in, CMS could cut as deep as 9-10% if the proposed rates become final on April Fool’s Day. The industry has little more than 5 weeks to howl, lobby, mobilize and cajole CMS to its senses before the meat-axe falls.
Obama Spikes Reform in SOTU Speech. Where Now for Medicare?
I hope you enjoyed the State of the Union (SOTU) address as much as I did — it’s the Super Bowl of policy geeks. I saw it as an effective rallying tool around a number of the President’s goals that will deeply challenge the GOP opposition, like an increase in the minimum wage and immigration reform. But it was the utter lack of any new ideas for Medicare that struck me — and definitely no olive branch to House Budget Committee Chairman US Rep. Paul Ryan (R-WI) on premium support. So where now for Medicare?
