CMS Has Begun To Collect Additional Data On Private Medicare Advantage Plans, Acting Administrator Says

Main Category: Medicare / Medicaid / SCHIP
Article Date: 03 Mar 2008 - 9:00 PDT

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CMS has begun to collect additional data on private Medicare Advantage plans, acting CMS Administrator Kerry Weems said on Thursday at a House Ways and Means Health Subcommittee hearing, CongressDaily reports. Weems comments were made in the context of a Government Accountability Office report released on Thursday that found MA plans can cost beneficiaries more than traditional Medicare for home health care, nursing homes and certain hospital stays. However, CMS "protested GAO's approach to the report, saying it did not focus on the advantages" of enrollment in MA plans, according to CongressDaily.

Democrats said that the report indicates the need for a reduction in reimbursements for MA plans. Subcommittee Chair Pete Stark (D-Calif.) said, "I see no reason that they have to be grossly overpaid and under-regulated." Stark added that he hopes the additional data collected by CMS will provide improved information about MA plans (Johnson, CongressDaily, 2/28).

Rep. Dave Camp (R-Mich.) said, "Clearly it's a fake report with fake conclusions, and we're having a fake hearing on it so we can all run to the media and make certain pronouncements," adding, "The report only looks at hypothetical beneficiaries, who use only certain types of services and enroll in a narrow selection of plans." He said that the report "does not reflect the reality of a single beneficiary" enrolled in MA plans and that opponents of such plans "will ignore the reality that the vast majority of plans actually provide much better cost-sharing benefits" (Reichard, CQ HealthBeat, 2/28).

In an e-mail, officials for America's Health Insurance Plans wrote, "By focusing on cost-sharing for individual services, without considering the entire episode of care, the report underestimates the value" provided by MA plans (Goldstein, Bloomberg/Hartford Courant, 2/29).

The GAO report is available online.

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