Acting CMS Administrator Kerry Weems told a House committee that for the first time his agency would conduct an analysis of the extra services that Medicare Advantage enrollees actually use rather than just what the participating plans offer.
Private insurers that make up Medicare Advantage often tout added benefits, such as coverage for hearing aids, eyeglasses and gym memberships, as the primary reason why they are paid on average 13% more than traditional fee-for-service Medicare. But the plans have never had to document how many beneficiaries actually take advantage of those extra services.
We have no idea what beneficiaries receive in Medicare Advantage because theres no requirement that the Medicare Advantage plans turn over any data on the services actually rendered to the government or to the beneficiaries, Rep. Pete Stark (D-Calif.), chairman of the House Ways and Means Committee's health subcommittee, said during a Capitol Hill hearing.
The data have long been sought by Stark and others who charge that Medicare Advantage has operated almost untouched by government oversight while being paid billions more than traditional Medicare. The move follows a new report from government auditors that some Medicare Advantage beneficiaries are actually spending more for home-health services and hospitalizations than those in traditional Medicare.
Rep. Dave Camp (R-Mich.), the panels senior Republican, however, assailed the report, saying that it is based on hypothetical issues rather than real world experience. -- by Matthew DoBias
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