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AHIP Comments On Proposed Rule That Would Alter The Medicare Advantage Payment Structure

posted by AHIP

on August 28, 2019

WASHINGTON, D.C. – Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP) issued the following statement following the association’s filing of its comment letter on a proposed rule that would make a variety of policy and technical changes to the Medicare Advantage (MA) program, including changes to the program’s payment structure:

Nearly 22 million Americans – about a third of all those eligible for Medicare – choose Medicare Advantage because it delivers better services, better care, and better value. Health insurance providers are accountable to the beneficiaries they serve as well as the taxpayers who fund the MA program. The Medicare Advantage program and its payment structure are designed to encourage health insurance providers to efficiently provide high-quality health care treatments and services to seniors and people with disabilities.

As we note in our comment letter, the risk adjustment data validation (RADV) changes in the proposed rule violate numerous statutory requirements and are fundamentally unfair and ill-conceived. Finalizing these provisions would undermine private sector confidence in the agency’s willingness to comply with the law and to act as a fair business partner – which could lead to higher costs, reduced benefits, and fewer MA plan options for seniors.

We urge CMS in the strongest possible terms to withdraw the proposed rule and establish a collaborative process with stakeholders to create a workable alternative. We look forward to continuing to work with the Centers for Medicare & Medicaid Services (CMS) to improve the health of the millions of Medicare beneficiaries our members serve.”

Read AHIP’s comment letter here.