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Letter toMarilyn Tavenner, Acting Administrator of the Centers for Medicare & Medicaid Services for the US Department of Health and Human Services - Sen. Toomey Advocates For Seniors On Medicare Advantage Benefits


Location: Washington, DC

Dear Ms. Tavenner:

We are concerned with the Centers for Medicare and Medicaid Services' (CMS) recent decision to calculate 2014 Medicare Advantage (MA) rates with the assumption that the Medicare physician fee schedule would be subject to a 25 percent reduction on January 1, 2014. CMS made this conscious choice despite strong historic precedence of Congress repeatedly intervening to avert scheduled cuts to the physician fee schedule.

Over fourteen million seniors have chosen to enroll in a Medicare Advantage plan, opting for comprehensive and coordinated health coverage. A recent national survey revealed that nine out of ten Medicare Advantage beneficiaries were satisfied with their plans. Unfortunately, the President's health care law significantly undermined the Medicare Advantage program, eliminating $308 billion from the program over the next ten years. According to the Congressional Budget Office (CBO), these reductions are anticipated to reduce MA enrollment by 23 percent.

In the Advance Rate Notice and Draft Call Letter published on February 15th, CMS deliberately chose not to exercise their discretion[1] to anticipate a suspension or fix to the sustainable growth rate (SGR). Instead, they chose to calculate 2014 MA rates based on the highly unlikely scenario that Congress would allow draconian cuts to the physician fee schedule to take effect. We respectfully request that CMS re-examine their statutory authority to address this issue and revise their estimates and calculations in a manner which anticipates that physician rates will remain at their current levels. Failure to acknowledge Congressional precedence on the SGR along with significant cuts in the President's health law will result in further destabilization of the MA market and reduced access for millions of seniors.

We recognize the importance of ensuring appropriate MA reimbursement and believe that a sound Medicare Advantage program can contribute to Medicare's long term sustainability and preserve the program for future generations.

We appreciate your consideration and look forward to your timely response.


Pat Toomey, US Senator
John Cornyn, US Senator
John Boozman, US Senator
Dean Heller, US Senator

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