CMS gives Medicare+Choice programs a raise

Sunday, January 18, 2004

January 19, 2004

WASHINGTON - CMS announced last week significant increases in federal payment rates for Medicare Advantage health plans, aimed at   supporting improvements in services and lower costs for Medicare beneficiaries enrolled in private health plans, as well as more options for Medicare coverage.
The increased payments to Medicare Advantage, formerly known as Medicare+Choice, will take effect March 1 and were included in the Medicare Prescription Drug, Improvement and Modernization Act recently signed into law by President Bush. The increases will average 10.6% across plans.
The provision requires managed care organizations to use the funds to:
- Reduce beneficiary premiums or co-pays
- Enhance benefits
- Stabilize or expand the network of doctors and other health care providers available to seniors
- Reserve funds to offset either premium increases or reduced benefits in the future.
The new provision gives managed care organizations that announced they were leaving Medicare Advantage (formerly Medicare+Choice) or reducing their services the opportunity to remain in the program, providing continued service for seniors who choose a managed care plan.
These organizations must submit new proposals to CMS for review by Jan. 30.