- Sen. Elizabeth Warren has called on the CMS to implement a payment rule that has been lambasted by payers who say it will cut Medicare Advantage rates.
- In a letter dated Monday to HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, Warren said people in traditional Medicare are paying higher premiums because of the “tricks” MA plans play “to squeeze billions of extra dollars out of the Medicare program.”
- The 2024 Medicare Advantage and Part D Advance Notice, released in February, proposed a 1.03% average MA revenue increase driven by a 2.09% growth rate, but insurers have argued that because of other changes, it would represent a 3.7% cut.
Insurance and provider lobbies called on the CMS to delay the proposed rule earlier this month, saying the methodology was flawed and arguing the 30-day comment period didn't give them enough time to analyze the proposed changes.
But Warren is calling for the agency to stick to its original timeline and finalize the proposal early next week.
“These proposed changes would modernize the MA risk adjustment model, limiting future overpayments to MA plans. I support these efforts, which are an important step towards addressing private insurers’ long history of exploiting the government out of billions of dollars,” she wrote.
Warren pointed to a report from the Medicare Payment Advisory Commission that estimates Medicare Advantage overpayments of $23 billion this year due to coding alone.
The Senator also said that those enrolled in traditional Medicare are paying higher premiums because of overpayments to MA plans, without receiving any of the extra benefits, amounting to $65 billion over the next eight years, according to a letter from policy analysts that includes former HHS and CMS employees.
In its comments on the rule, health insurance lobby AHIP said the rate change would lead to higher premiums or reduced benefits that would particularly affect those dual-eligible for both Medicaid and Medicare.
The proposed rate change comes as the CMS is attempting to recollect on overpayments to MA plans, including an announcement in January it would be conducting audits to potentially recoup billions of dollars from insurers.