U.S. Rep. Vern Buchanan (R-FL) this week helped lead a bipartisan call for the Biden administration to ensure that the final rate announcement for the Medicare Advantage (MA) program accurately reflects growth rates and healthcare cost increases.
“I am deeply concerned about the administration’s proposed rate notice for Medicare Advantage [MA] health plans,” Rep. Buchanan said on Tuesday. “At a time when more than half of the Medicare beneficiary population is enrolled in an MA plan, coupled with still stubbornly high levels of inflation that is pinching the pocketbooks of everyday Americans, the last thing we should be doing is raising healthcare costs on our nation’s seniors, many of whom are living on fixed incomes.”
Rep. Buchanan and 19 of his colleagues reiterated that stance in a March 25 letter sent to U.S. Department of Health and Human Services Secretary Xavier Becerra and Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, urging them to reconsider CMS’s proposed rate notice to the MA program that they say could impact senior citizens’ access to care and undermine the program. CMS is slated to finalize the rule by April 1.
“It is essential for the over 33 million seniors and individuals with disabilities currently enrolled in MA that the CMS keep payments to the program stable during a time of increased demand for care, as well as the implementation of significant changes stemming from recent rulemaking,” wrote Rep. Buchanan and his colleagues. “Payment stability will ensure that premiums remain affordable, popular supplemental benefits remain intact, and provider reimbursements remain competitive.”
Among the members who joined Rep. Buchanan in signing the letter were U.S. Reps. Mike Kelly (R-PA), Michelle Steel (R-CA), Blake Moore (R-UT), Carol Miller (R-WV), Mike Carey (R-OH), Darin LaHood (R-IL), Adrian Smith (R-NE), Randy Feenstra (R-IA), Ron Estes (R-KS), Brian Fitzpatrick (R-PA), and Darren Soto (D-FL).
The lawmakers pointed out that CMS proposes an effective growth rate of 2.44 percent when calculating the 2025 benchmark, which doesn’t fully account for the increases in utilization over the past year, in part because it doesn’t include utilization data from the fourth quarter of 2023, according to their letter.
“We are concerned that the proposed MA growth rate, combined with higher-than-expected utilization, could result in providers receiving lower reimbursement rates for their services, as well as increased premiums or reduced supplement benefits provided to beneficiaries,” wrote Rep. Buchanan and the members. “We urge CMS to closely consider all appropriate data and information, including data indicating higher trends in Q4 2023, to ensure that growth rates in the final rate notice reflect recent seniors’ expected healthcare needs in 2025.”
By considering Q4 2023 data, they wrote, CMS could ensure that the MA program maintains its affordability, benefits, and choices for the program while improving its quality and long-term stability for America’s seniors and those with disabilities.