Medicare News
| For Immediate Release: | Contact: |
| Thursday, February 11, 1999 | CMS Office of Public Affairs 202-690-6145 |
For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov. |
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REFINEMENTS MADE TO MEDICARE+CHOICE PROGRAM
PATIENT PROTECTIONS, ACCESS TO INFORMATION AND REDUCTIONS IN ADMINISTRATIVE BURDENS INCLUDED IN NEW RULES
The Health Care Financing Administration today announced refinements to the Medicare+Choice program that improve beneficiary protections and access to information while making it easier for health plans to offer more options to beneficiaries.
HCFA is working with Congress to give plans an additional two months to file the information that is used to approve the benefits and premiums offered to Medicare beneficiaries. The move from May 1 to July 1 should help managed care plans base the costs and premiums for health care to Medicare beneficiaries on current trends and costs in the health care marketplace.
Today's announcements also include the creation of a federal advisory committee to help HFCA reach out to Medicare beneficiaries and better inform them about changes in the Medicare program, while learning from beneficiaries what information they want and need and the best ways to get it to them.
"These steps will help us start fulfilling President Clinton's commitment to improve protections for beneficiaries when plans leave Medicare," HHS Secretary Donna E. Shalala said. "They should also make it easier for plans to continue to serve Medicare beneficiaries."
"We're establishing the advisory committee to help us make sure that our education efforts will help beneficiaries navigate the world of managed care," HCFA Administrator Nancy-Ann DeParle said. "At the same time, it's clear that we can ease the administrative burden on plans without compromising beneficiary protections. And that will help plans provide beneficiaries with even more choices."
The Balanced Budget Act of 1997 established the Medicare+Choice program which expands the range of health care options available to Medicare beneficiaries and provides them with information they can use to make informed decisions about how they want to receive their health care. In June 1998, HCFA published an interim final rule to implement the new Medicare+Choice program. The new rules make several changes in response to public comments on the interim final rule. The adjustments include stronger beneficiary protections while making the administrative requirements on plans taking part in Medicare+Choice less burdensome. HCFA expects to issue a more extensive final rule later this year.
As part of the Medicare+Choice program, HCFA created the National Medicare Education Program, a comprehensive communications effort which includes expanded and updated print materials such as the Medicare&You handbook; a toll-free telephone line -- 1-800-MEDICARE (1-800-633-4227) -- and a beneficiary-oriented Internet web site -- www.medicare.gov, as well as a coordinated partnership program with more than 200 national and local organizations who work with Medicare beneficiaries.
As an addition to these initiatives, HHS and HCFA are establishing the Citizens Advisory Panel on Medicare Education to provide a broad range of public input into the operation of HCFA's National Medicare Education Program. A public call for membership nominations will appear shortly in the Federal Register.
To help make sure the Medicare education program is as effective as possible, the members of the Citizens Advisory Panel on Medicare Education is expected to include representatives of organizations representing older Americans; specific diseases and disabilities; minority communities; health communicators; health services researchers; health insurers and plans; health providers and clinicians; labor and retirement interests; and the general public.
The new rule assures that Medicare beneficiaries have the opportunity to enroll in other Medicare managed care plans in their community if they are enrolled in a managed care plan that withdraws or is terminated from the Medicare program. This provision should help those Medicare beneficiaries who choose to remain in managed care.
The rule also reduces a number of administrative responsibilities identified in the June 26 interim final rule. These include requirements for health assessments of beneficiaries enrolled in a managed care plan. The new rule allows the requirement for an initial assessment within 90 days of enrollment to be considered met for commercial health plan enrollees who remain in the same managed care organization's Medicare+Choice plan when they become eligible for Medicare at age 65 or for enrollees who switch plans but remain under the care of the same primary care provider. The rule also gives managed care plans the ability to choose the form of the initial assessment.
"Together, all of these provisions and improvements to the Medicare+Choice program should help both Medicare beneficiaries and the managed care plans that many have come to rely on for their health care needs," DeParle said.
