Res. Comm. Pedro Pierluisi

Representing the At Large District of PUERTO RICO

Pierluisi Statement on Final 2017 Medicare Advantage Payment Rates

Apr 5, 2016
Press Release
Rule could increase annual funding to Puerto Rico by $430 million

San Juan, Puerto Rico—Resident Commissioner Pedro Pierluisi today released the following statement on the final 2017 Medicare Advantage Payment rates:

“Last night, the Centers for Medicare and Medicaid Services, within the U.S. Department of Health and Human Services, released its final rule setting forth payment policies for Medicare Advantage plans for 2017.  I and others have been fighting hard to stabilize and strengthen the Medicare Advantage program in Puerto Rico, which provides health insurance to nearly 570,000 seniors and disabled individuals on the island, including nearly 300,000 low-income seniors who are enrolled in both Medicare and Medicaid, which is known in Puerto Rico as Mi Salud.

“Although I am still reviewing the details of the final rule, my preliminary reading indicates that we have achieved a very positive result.  According to a summary released by CMS, ‘CMS will implement a number of changes in 2017 that will significantly benefit Medicare Advantage enrollees in Puerto Rico.’  The summary further states:  ‘As a result of the finalized policies, the expected revenue change for Medicare Advantage Plans in Puerto Rico is 1.25 percent.’  According to one estimate I have received, the final rule will result in an increase in annual funding to Puerto Rico of approximately $430 million per year.  

“I will provide more details as soon as they become available, but this appears to be excellent news on what was otherwise a very difficult day in Puerto Rico.  I want to express my gratitude to Secretary Burwell and the team she leads at HHS and CMS for their personal attention to this extraordinarily important matter.

“Notwithstanding this positive development, there is still much work that remains to be done to ensure that Puerto Rico is treated fairly under federal health programs, whether it be Medicaid, traditional Medicare or Medicare Advantage.” 

To see the CMS summary of how the final rule affects Puerto Rico, see here: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-04-04-2.html.