 |
| Domenici & Wilson: Agreement Reached To Increase Medicare Choice Reimbursements |
October 11, 2000 |
| |
| WASHINGTON -- U.S. Senator Pete Domenici and Congresswoman Heather Wilson today reported that Senate and House negotiators have reached an agreement to increase Medicare reimbursement rates in an effort to ensure that thousands of New Mexico seniors do not lose the health care benefits offered through Medicare-HMO plans.
Both Wilson and Domenici have been pushing for fairer and increased reimbursement rates as part of a so-called “Medicare adjustment” package now being finalized in Congress. Without improving the Medicare Choice rates, about one million seniors–including 15,000 in New Mexico–stand to lose health care coverage as their Medicare-HMO providers pull out of the Medicare Choice program because of unfair reimbursement rates.
Negotiators have tentatively agreed to increase the Minimum Payment Floor to $525 a month per beneficiary in 2001 for all Metropolitan Statistical Areas (MSA’s) with populations exceeding 250,000. The health care providers in the Albuquerque MSA are currently reimbursed at $430 per beneficiary. Under the deal, the Albuquerque area would see an increase of $95 ($430 to $525) per beneficiary per month, resulting in at least an additional $34 million for New Mexico in FY2001.
In addition, the agreement would increase the Payment Floor for Rural Areas from the current $415 to $475 in 2001. Overall, the plan will cost about $4.4 billion over five years (2000-05).
“This agreement should allow Medicare Choice to remain a viable option for seniors in New Mexico, who gain from such plans because they offer affordable benefits like prescription drug coverage,” said Domenici, who in July introduced the Medicare Geographic Fair Payment Act of 2000 (S.2937) to increase reimbursement rates and keep Medicare-HMO benefits available to at-risk seniors.
“This agreement should keep managed care as an option for New Mexicans who want it. It has been an uphill fight and this is great news.” Wilson said, who introduced the Fair Care for Seniors Act (H.R.5001) in July.
In late September, Wilson was instrumental in gaining House Commerce Committee approval for a plan that increased Medicare Choice reimbursements to the $457 and $525 levels.
The Health Care Finance Administration (HCFA) this summer reported that nearly 1 million seniors could lose their Medicare Choice coverage by 2001, possibly forcing them to return to the traditional Medicare Fee-for-Service program. Over the past three years, more than 1.7 million seniors have already been forced out of Medicare Choice plans because of unfair reimbursement rates.
Of the at-risk seniors, an estimated 15,000 of the 45,000 New Mexico seniors enrolled in Medicare Choice programs could lose coverage. In July, Presbyterian Healthcare Services, Lovelace Health Systems, QualMed Plans for Health and St. Joseph Healthcare in New Mexico informed HCFA of their intention to withdraw from the Medicare Choice program.
Under HCFA’s administration, reimbursement rates around the country have varied widely, with private health maintenance organizations dropping out of the Medicare Choice program in communities where reimbursement rates are lowest. For example, while patient care reimbursement rates are now $814 for Staten Island and $794 for Dade County, Fla., they are only $430 for Albuquerque and $453 for Portland, Ore., for the same senior services.
“This agreement will work to stop the blatant discrimination against states, like New Mexico and Oregon, that deliver health care in an efficient manner. We cannot continue to promote the administration of this program in a manner that penalizes efficient states and rewards those states that get more money for being inefficient in delivering health care,” Domenici said.
--30-- |
|
|
|