Medicare Advantage (MA) benefits for seniors will be preserved, U.S. Senator Pat Toomey (R-Pa.) learned recently. The Centers for Medicare and Medicaid Services (CMS) announced that it has changed its position and will not assume that the physician fee schedule will be cut 25 percent in 2014. Just last week, Senator Toomey sent a letter to CMS' Acting Administrator Marilyn Tavenner expressing concern at a previous decision that would have shrunk Medicare Advantage benefits for millions of seniors.
In the Advanced Rate Notice and Draft Call Letter released on Feb. 15, CMS revealed that they would not include a fix to the sustainable growth rate (SGR) in calculating 2014 MA rates. Instead, the rates would have been based on the highly unlikely scenario that Congress would allow draconian cuts to the physician fee schedule to take effect on January 1, 2014. Sen. Toomey questioned this decision in his letter.
Had CMS maintained their position - to not to include an 'SGR fix' - the value of benefits offered by MA plans would have declined. These benefits may have included such items as glasses, hearing aids, and dental cleanings. The 'SGR fix' in the 2014 MA benchmark will not result in additional cost to taxpayers.
"I am relieved that Pennsylvania's seniors will not take another hit," said Sen. Toomey. "More than one-third of Pennsylvania's Medicare beneficiaries receive coordinated health care through a Medicare Advantage plan. It's great news that the Centers for Medicare and Medicaid Services will not reduce health benefits for more than 800,000 Pennsylvanians. It is critical to ensure appropriate Medicare Advantage reimbursement. I believe that a sound Medicare Advantage program can contribute to Medicare's long term sustainability and preserve the program for future generations. I appreciate that Acting Administrator Tavenner considered my letter and reversed course."