The Center for Public Integrity is suing the federal government to obtain records related to the Medicare Advantage program. The not-for-profit, non-partisan watchdog group filed a lawsuit in U.S. District Court on Tuesday seeking to force HHS to turn over records that were requested more than a year ago under the Freedom of Information Act.
Specifically, the center is seeking all records related to audits or investigations conducted by the federal government during the last five years of insurance companies offering private Medicare plans. In addition, the group is requesting risk-coding scores—which determine how much a health plan is paid—for all Medicare Advantage enrollees since 2004 and all congressional correspondence about the program.
The public records request was initially filed May 21, 2013. HHS acknowledged receiving the request last June, but has not followed through with any of the records, according to the lawsuit.
“The information about Medicare Advantage that we are asking for should be readily available to the taxpaying public,” said Bill Buzenberg, executive director of the Center for Public Integrity. “There's no excuse for ignoring our request.”
Roughly 16 million Medicare beneficiaries are currently enrolled in private plans. That's about 30% of the total Medicare population.
Historically, private insurers have been paid significantly more to provide coverage for seniors compared to what the traditional fee-for-service Medicare program costs. In 2010, according to the Medicare Payment Advisory Commission (PDF), the average Medicare Advantage enrollee cost 113% as much as their counterparts in the traditional program.
Under the Patient Protection and Affordable Care Act, payment cuts have reduced that disparity. However, the average payment (PDF) to health plans is still 106% of the cost of traditional Medicare enrollees in 2014.
Spokesman Aaron Albright said HHS cannot comment on pending litigation.
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