House Members Have Concerns on Proposed Medicare Changes

Members of the House Ways and Means and Energy and Commerce committees have sent a letter informing Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt about their concerns over recent CMS proposals.

The letter, dated March 4, responds to the agency’s proposed changes to Medicare Advantage and Medicare Part D programs and plans for 2017 and asks several questions about CMS’ expected effects of the proposals lawmakers say they are concerned about. The letter is signed by bipartisan leaders of both full committees and respective health subcommittees.

One issue raised is on encounter data. The lawmakers said their previous concerns about CMS’ preparation to adopt 10 percent of encounter data as part of the risk adjustment still stand. They questioned Slavitt about what the agency has done to address concerns from groups such as MedPAC and the Government Accountability Office on the issue.

Another area of concern noted is how employer group waiver plans, which cover insurance plans for retirees, will be impacted by proposed cuts. The lawmakers asked what proposed cuts would mean for employers and beneficiaries, and whether the proposed time frame could affect employers.

A third area of concern for committee members is how risk adjustment changes will affect plans. “Given regional disparities, variation in plan enrollment of full and partial dual populations, and the adjustments that must be made to benefit structures and plan businesses, we think it is critical that CMS ensure plans are afforded a reasonable amount of time to adjust as these new policies are implemented,” they write.

The lawmakers added that they were pleased by the agency’s proposals to better support dual-eligible beneficiaries who qualify for both Medicare and Medicaid. Proposals implying Medicare Advantage plans could qualify as alternative payment models were also positive, they wrote, noting how that would support legislation passed last year.

“As envisioned by the Medicare Access and CHIP Reauthorization Act (MACRA), APMs allow for a large array of health care providers to participate in coordinated efforts to increase efficiency, lower costs, and bring higher quality care to our sneers and people with disabilities,” the lawmakers wrote.