Special Needs Plans Seek To Avoid Moratorium By Providing More Data To Congress

Main Category: Medicare / Medicaid / SCHIP
Article Date: 28 Apr 2008 - 6:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Officials from special needs plan providers said Thursday at a Capitol Hill briefing that they will provide Congress with more data on the services the plans provide to beneficiaries with severe chronic medical conditions, CQ HealthBeat reports. SNPs are offered through Medicare Advantage and serve so-called "dual eligibles," beneficiaries who qualify for both Medicaid and Medicare; beneficiaries with severe or disabling chronic conditions; and beneficiaries in long-term care facilities. The plans were added under the 2003 Medicare law and since then have accounted for "much of the surge in overall [MA] enrollment," according to CQ HealthBeat.

However, the "plans haven't convinced some policy analysts that they are developing real expertise in managing care for Medicare's neediest enrollees in spite of the higher payment rates they receive," CQ HealthBeat reports. Under Medicare legislation (S 2499) signed by President Bush in December 2007, SNPs cannot expand their service areas and no new plans can be introduced through Dec. 31, 2009. Supporters of SNPs are seeking to get the moratorium lifted through Medicare legislation currently being debated in Congress (Carey, CQ HealthBeat, 4/24).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.