MANAGED CARE February 2009. ©MediMedia USA
With the Obama administration moving quickly to take the reins at Medicare, officials recalled a draft of the 2009 Medicare Advantage and Part D call letter, signaling that changes are probable.
“Some of the Medicare advocates as well as folks on the Hill like California Democrat Pete Stark have called on the Obama administration to rescind it and put their own stamp on it,” says Paul Precht, director of policy and communications at the Medicare Rights Center.
“We want to ensure that benefits provided by Medicare Advantage plans provide adequate financial protection, are easier to understand, and are transparent for the consumer.”
Some cost-sharing techniques that can prove a nasty surprise for members are likely to be at the top of the list of upcoming changes, which would be put in place for 2010.
“We’ve seen plans with out-of-pocket limits that exclude certain services,” adds Precht. “Sometimes we find out those services are Part B drugs, which includes chemotherapy. We would want language to say more definitely that that type of arrangement is not acceptable.”
The letter also provoked a quick cheer from Pete Stark, the chairman of the House Ways and Means Health Subcommittee and a longtime critic of Medicare Advantage.
“This letter would have locked in another year of lax Bush-era guidelines for private insurers in Medicare, and I am pleased that the Obama administration rescinded this letter,” he said in a statement.
Medicare Advantage plans should not have long to wait to find out exactly what the new administration has in mind.
“We recognize that MA organizations and PDP sponsors need to have 2010 guidance available in order to prepare their bids by the statutory deadline, and therefore [we] will post a draft reflecting any changes resulting from a review of the current draft as soon as possible,” CMS said.