Medicare News
| For Immediate Release: | Contact: |
| Monday, September 09, 2002 | 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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MEDICARE MANAGED CARE PLAN EXPANDS TO INCLUDE BENEFICIARIES IN FOUR NEW MEXICO COUNTIES
The Centers for Medicare and Medicaid Services (CMS) today approved a request by Presbyterian Health Plan Inc. to expand managed care coverage to Medicare beneficiaries in four counties in New Mexico.
Presbyterian Health Plan, based in Albuquerque, N.M., can begin on Jan. 1, 2003, to serve beneficiaries in Torrance County and portions of Cibola, Santa Fe and Socorro counties in north central New Mexico. The expansion includes southern Santa Fe County, northern Socorro County and a majority of Cibola County including the cities of Grants and Casa Blanca. The newly expanded service area includes about 7,000 Medicare beneficiaries.
The plan currently serves beneficiaries in the New Mexico counties of Bernalillo, Sandoval and Valencia, including the cities of Albuquerque and Rio Rancho, and a portion of Cibola County.
"We are pleased that Presbyterian Health Plan has decided to offer this new option to more Medicare beneficiaries in New Mexico," HHS Secretary Tommy G. Thompson said. "The reality is, Medicare should provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The President's principles for strengthening and modernizing Medicare will move us closer to that goal."
"We want to make sure all Medicare beneficiaries, whether in a Medicare+Choice plan or fee-for-service, are receiving the highest quality health care," CMS Administrator Tom Scully said. "We are doing more to guarantee that beneficiaries understand the Medicare coverage options available to them. We also are reminding beneficiaries of the need to work closely with the doctors and other health care providers that give them medical care."
The plan will give another health care option to Medicare beneficiaries in the newly approved service area. Beneficiaries in the four counties currently have Sterling Life Insurance Co. as another choice. Lovelace Senior Plan and St. Joseph Medicare Plus also are available in Santa Fe and Torrance counties.
In his budget proposal for fiscal year 2003, President Bush said the current Medicare+Choice system for paying private plans is not giving beneficiaries the health care options they deserve. Annual increases in Medicare+Choice funding have failed to reflect rising health care costs, leading to unreliable options and reduced benefits for seniors. Under the President's proposal, all Medicare+Choice plans will receive payment increases in 2003.
Medicare+Choice HMOs and fee-for-service plans are available where private companies choose to offer them. Currently, about 5.6 million Medicare beneficiaries -- out of a total of nearly 40 million aged and disabled Americans -- have enrolled in Medicare HMOs. Original fee-for-service Medicare, currently chosen by more than 34 million beneficiaries, is available to all beneficiaries.
Congress created Medicare+Choice in the Balanced Budget Act of 1997 to expand the types of health care options available to Medicare beneficiaries, who in addition can now receive new preventive benefits and patient protections. There also is a far-reaching consumer information program that includes a national toll-free phone number -- 1-800-MEDICARE (1-800-633-4227, or TTY/TDD, at 877-486-2048 -- an Internet site -- www.medicare.gov -- and a coalition of more than 200 national and local organizations to provide seniors more information.
