|
|
|
_ As
documented in various CMA
Alerts, there is consistent and growing evidence that Medicare
Advantage (MA) plans are paid more on average than traditional Medicare
spends on a given beneficiary, and such spending is growing per person, with
significant implications for Medicare programmatic spending (see, e.g., here and here). These overpayments stem, in part,
from MA plans “upcoding” – reporting their enrollees as being more sick or
requiring more intense levels of care than their medical records support in
order to receive higher risk-adjusted payment. Over
the last week, the Centers for Medicare & Medicaid Services (CMS) issued
long-awaited rules concerning audits of MA plan payments, as well as proposed
MA plan payment rates for 2024. Together, these actions reflect an effort to
both acknowledge and confront excessive payment to MA plans, but do these
actions fall short? Will they be enough to stem the tide of wasteful
payments that could otherwise be used to shore up Medicare’s solvency and
expand benefits and coverage for all Medicare beneficiaries?
The Center for Medicare Advocacy (http://www.medicareadvocacy.org) is a
national, non-profit, law organization that works to advance access to
comprehensive Medicare coverage, health equity, and quality health
care for older people and people with disabilities. Founded in 1986, the
Center focuses on the needs of people with longer-term and chronic
conditions. The organization’s work includes legal assistance, advocacy,
education, analysis, policy initiatives, and litigation of importance to
Medicare beneficiaries nationwide. Our systemic advocacy is based on the
experiences of the real people who contact the Center every day.
Headquartered in Connecticut and Washington, DC, the Center also has
attorneys in CA, MA, and NJ. Center for Medicare Advocacy, Inc. • www.MedicareAdvocacy.org • PO Box 350, Willimantic, CT 06226 • 1025 CT Ave. NW, Washington, DC 20036 |
No comments:
Post a Comment