Medicare

State of Play:  The Centers for Medicare and Medicaid Services (CMS) has issued an unprecedented array of temporary regulatory waivers and new rules to help Medicare Advantage (MA) and Part D sponsors better respond to the COVID-19 pandemic.  All of the changes to date are effective for the duration of the COVID-19 national emergency. Before COVID-19 response became a top priority, CMS issued its proposed rule on Medicare Advantage and Part D prescription drug programs for 2021 and launched the Part D Senior Savings Model for insulin.  As concerns about healthcare are front and center, support for Medicare-for-All has also grown.  A recent Morning Consult poll found 55 percent of voters support Medicare-for-All, its highest level recorded since June 2019.   In January, a Kaiser Family Foundation Health Tracking poll found large majorities supporting both a public option and Medicare-for-All, but the public option was more popular, with 73 percent support. Colorado is considering legislation to create a public option and establish a base payment rate for hospitals. 

HLC Position:  HLC supports the Medicare program’s modernization through tools   developed and used successfully in the private sector and adopted for use by the MA and Part D programs.  HLC also favors continued improvements to the consumer-focused MA and Part D programs while protecting the fundamental structures that have made them successful.  HLC opposes Medicare-for-All approaches, including other permutations such as a public option and Medicare and Medicaid buy-in proposals that could adversely affect care delivery.  HLC continues to educate members of Congress about the success of the private sector in delivering high-quality, cost-effective care to patients and consumers in the Medicare program. 

HLC Recent Activity:

  • On April 6, HLC submitted comments to CMS on contract year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.
  • On March 6, HLC wrote CMS in response to the “Advance Notice of Methodological Changes for Calendar Year 2021 for the Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.”
  • On March 4, HLC joined a letter to CMS on recommendations to enhance the Medicare Plan Finder.
  • On March 2, HLC wrote CMS in response to the notice of proposed rulemaking entitled, “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental Plans.”
  • On February 26, HLC participated in a CMS strategy session on the Medicare Plan Finder.
  • On February 3, HLC issued a press release endorsing H.R. 5471, the “Strengthening Innovation in Medicare and Medicaid Act.”
  • HLC continues to partner with the Better Medicare Alliance, advocating the enhanced value MA plans offer in comparison to fee-for-service.
  • HLC continues to sit on the executive committee for the Partnership for America’s Health Care Future, an alliance committed to preventing legislation that would lead to single- payer healthcare, expanding Medicare, or creating Medicare for All, in particular.
  • On November 20, HLC responded to CMS’s request for information on “Using Advanced Technology in Program Integrity” specifically as it relates to Risk Adjustment Data Validation audits.
  • HLC continues to work with congressional offices on legislation to place parameters around Center for Medicare and Medicaid Innovation (CMMI) operations.
  • On October 15, HLC shared open enrollment information via the Seniors Speak Out platform, which serves as a resource for older Americans, caregivers, and advocates to help ensure seniors have access to high-quality healthcare.
  • On October 3, HLC issued a press release supporting the administration’s EO on Medicare.
  • On September 26, HLC wrote CMS expressing concerns regarding the “Medicare Program: Specialty Care Models to Improve Quality of Care and Reduce Expenditures” proposed rule.
  • On September 19, HLC issued a press release expressing concerns about H.R. 3, the “Elijah E. Cummings Lower Drug Costs Now Act.”
  • On August 7, Medicare Today, which HLC chairs, released a survey that shows seniors are satisfied with their Medicare, Part D prescription drug coverage.
  • On July 29, the Partnership for America’s Health Care Future, of which HLC is a member of the executive committee, released a survey that shows the majority of registered voters surveyed prefer fixing the current healthcare system over implementing a Medicare for All plan or establishing a public health insurance option.
  • On July 19, HLC wrote Representatives Ami Bera (D/CA) and Jason Smith (R/MO) in support of H.R. 3796, the “Health Savings for Seniors Act.”
  • HLC continues to lead the Healthcare Leaders for Accountable Innovation in Medicare and Medicaid (AIM) coalition. The coalition developed recommendations to improve the Center for Medicare and Medicaid Innovation (CMMI) and is sharing these recommendations with congressional offices while simultaneously working with several congressional offices on potential legislative language.
  • On June 26, HLC joined a sign-on letter with the Council for Affordable Health Coverage in support of legislation to provide for the utilization of real-time benefit tools in the Medicare program.
  • On June 26, HLC wrote the House Ways and Means Committee (W&M) in advance of its health markup, which included consideration of H.R. 3417, the “Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act.”
  • On June 4, HLC wrote the House Energy and Commerce (E&C) Committee and W&M Committee opposing proposed legislation for an out-of-pocket cap within the Medicare Part D program.
  • On June 4, HLC wrote the E&C health subcommittee in advance of its hearing on “Investing in America’s Health Care” supporting the extension of Medicare programs.
  • On May 22, HLC wrote the House Budget Committee in advance of its hearing on “Key Design Components and Considerations for Establishing a Single-Payer Health Care System” expressing concerns about this proposal.
  • On May 8, HLC wrote the Senate Finance Committee in advance of its hearing on “Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead.”
  • On May 2, HLC hosted Center for Medicare and Medicaid Innovation (CMMI) Special Assistant to the Director William Robinson and CMMI Chief Strategy Officer Gary Bacher to discuss CMMI’s strategies and priorities, including the new primary care payment model demonstration.
  • On April 30, HLC wrote the House Rules Committee expressing concerns regarding H.R. 1384, the “Medicare-For-All Act.”
  • On April 26, HLC hosted a Medicare-for-All webinar discussing the role of the private sector in advancing healthcare quality and innovation, how consumer choice and competition drive value, and the potential ramifications various proposed new models have for healthcare delivery.
  • On April 22, HLC applauded CMMI in a press release for a new primary care payment model demonstration that will bring greater value to primary care and improve outcomes in patients with complex, chronic conditions.
  • On April 10, HLC issued a press release opposing Medicare-for-All legislation introduced in the U.S. Senate.
  • On March 7, HLC wrote the Senate Special Committee on Aging, supporting the continued streamlining of Food and Drug Administration’s (FDA) responsibilities and processes.
  • On March 4, HLC hosted Lauren Crawford Shaver, executive director of the Partnership for America’s Health Care Future, at an HLC Policy Committee meeting, discussing recent polling data examining views on single-payer proposals such as Medicare-for-All, Medicare buy-in, and a public option.
  • On March 1, HLC wrote Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma in response to the 2020 MA and Part D draft call letter applauding CMS efforts to address social determinants of health through special supplementary benefits for the chronically ill.
  • On February 27, HLC issued a press release opposing Medicare-for-All legislation introduced in the U.S. House of Representatives.
  • On February 15, HLC signed onto a group letter with the Diabetes Advocacy Alliance to CMS Administrator Verma on possible modifications that would improve the accessibility and uptake of the Medicare diabetes prevention program benefit.
  • HLC continued leading the Healthcare Leaders for Accountable Innovation in Medicare and Medicaid coalition. The coalition shared its concerns about the “international pricing index” model for Part B drugs with the administration, conducted capitol hill meetings on this issue, and recruited coalition members to do op-eds to raise attention on this issue.
  • On January 14, HLC joined a sign-on letter with the National Osteoporosis Foundation on protecting patient access to medication in the Medicare Part D program.