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March 20, 2018 12:00 AM

Lawmakers urge CMS to increase Puerto Rico's Medicare Advantage rates

Virgil Dickson
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    Puerto Rico Resident Commissioner Jenniffer González-Colón

    Several congressional lawmakers have asked the Trump administration to address a long-time disparity in Medicare reimbursement rates for Puerto Rico that has affected residents' access to care.

    Nearly 20% of the island's population, or 580,000 people, are on Medicare Advantage plans. Lawmakers hope the CMS will boost Puerto Rico's Medicare Advantage rates for 2019 this spring. Puerto Rico's Medicare Advantage reimbursement rate is 43% below the national average and 26% below that of its neighbor, the U.S. Virgin Islands, according to a Tuesday letter from Puerto Rico Resident Commissioner Jenniffer González-Colón, Rep. José Serrano (D-N.Y.) and 23 other congressmen to HHS Secretary Alex Azar.

    In February, the CMS released a proposed pay notice which would bump up the overall baseline Medicare Advantage rates by 1.84%.

    "Unfortunately, the recently issued draft notice does not come close to addressing this long-standing disparity—it leaves payment rates at over 40% less than mainland rates," the letter said.

    The current rate woes have led to an exodus of providers, worsening patient access to care.

    "This disparity has to end if we have any hope of improving the precarious health system of the island," Serrano said in a statement.

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