With the recent announcement that health care providers Humana and PrimeCare would largely discontinue their Medicare+Choice coverage plans in Racine and Kenosha Counties, thousands of Southern Wisconsin Medicare beneficiaries were facing an uncertain future.Those enrolled in the plan had come to rely on the comprehensive healthcare coverage that is offered under the Medicare+Choice program.
I was pleased, however, to recently report some very positive news to with those affected by the PrimeCare Gold and Humana decisions.
First, legislation that I recently cosponsored, the Medicare Balanced Budget Refinement Act (H.R. 3075), passed the U.S. House of Representatives. This legislation provides a comprehensive 15-point plan to adjust the current Medicare payment structure and to provide incentives for expanded healthcare service choices here in Wisconsin. Provisions included in the bill attempt to correct several Medicare coverage problems by providing financial incentives to health providers to maintain, reenter, and enhance the service options available to seniors.
To address the particular situation in Racine County, I authored several legislative amendments tailored to meet the needs of local beneficiaries and health providers. Under this legislation, Racine County will be provided long-overdue increases in Medicare reimbursement rates.
Following passage of this legislation, I approached Blue Cross & Blue Shield United of Wisconsin to discuss the possibility of providing Medicare+Choice services to Racine County seniors.
We then worked to bring Blue Cross & Blue Shield together with All Saints Healthcare System, Inc. into a series of negotiations to work out an arrangement to pick up the coverage to be dropped by PrimeCare and Humana. At the same time, we worked with national and regional Health Care Financing Administration (HCFA) officials to streamline the necessary approval process.
Our goal was to ensure that Racine County seniors would continue to have access to a Medicare+Choice plan with no lapses in coverage.
On Monday, November 8th, I, along with officials from Blue Cross & Blue Shield United of Wisconsin and All Saints Healthcare System, Inc., announced that an agreement had been reached. It was then announced that Medicare+Choice coverage would be initiated to cover the plans previously offered by PrimeCare Gold and Humana.
We should again thank all those who went the extra mile to get us to where we are at today. The management and employees of Blue Cross & Blue Shield and All Saints Healthcare System have exemplified what being a good corporate citizen is all about and they deserve great praise for their efforts. Also, we should thank HCFA for making an exception for this agreement to proceed and expediting the normal process so that local beneficiaries could continue to be covered by Medicare+Choice without interruption.