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Kaiser Report Highlights Recent Medicare Developments

Armen Hareyan's picture

Summaries of several recent developments related to Medicare appear below.

Marketing requirements: CMS has implemented new requirements on marketing for private fee-for-service Medicare Advantage plans, such as stronger "disclaimer"language, the Wall Street Journal reports. The language states that such plans do not guarantee Medicare beneficiaries will have the ability to visit the same physician they used before they switch plans. Such plans also must make "verification" calls to ensure that new enrollees understand the plans (McGinley, Wall Street Journal, 9/9). In related news, a recent Consumers Union analysis of data collected from 10 states found that Medicare prescription drug plans in which CMS automatically enrolls some low-income beneficiaries can require beneficiaries to pay more than necessary for popular medications (Edney, CongressDaily, 9/12).

Medical imaging: GE Healthcare President and CEO Joseph Hogan and other medical imaging company officials on Monday met with presidential advisers to "press their case that their industry is being asked to bear an unfair burden as Congress and the administration look to rein in Medicare spending," The Hill reports. The Advanced Medical Technology Association, the Medical Imaging and Technology Alliance division of the National Electrical Manufacturers Association and the Access to Medical Imaging Coalition have launched a campaign against several consecutive years of reductions in Medicare reimbursements for the use of their products.Lawmakers have focused on medical imaging because Medicare spending inthat area doubled from 2000 to 2005 (Young, The Hill, 9/12).

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Medicare tax: Rep. Sander Levin (D-Mich.) has introduced legislation that would classify the earnings of hedge-fund and private-equity managers as compensation subject to the 2.9% Medicare tax, Bloomberg/Salt Lake City Deseret Morning News reports. Current law classifies such earnings as capital gains, which are not subject to Medicare and other payroll taxes. The legislation change would increase federal revenue by as much as $1 billion annually(Fitzgerald, Bloomberg/Salt Lake City Deseret Morning News, 9/11).

Private fee-for-service plans: Lower-income beneficiaries enrolled in private fee-for-service MA plans who live in lower-income counties pay more for benefits than those enrolled in the same plans who live in nearby,higher-income areas, according to a study recently released by the Medicare Rights Center, CQ Health Beat reports. According to the report, which compares U.S. Census Bureau demographic data with the premiums and benefits of such plans in eight counties in four states, plans in higher-income counties receive higher federal subsidies per enrollee than those in nearby, lower-income counties with larger numbers of minority residents. MRC President Robert Hayes said, "Current members of Congress and the insurance lobby have been working overtime to sell the argument that overpaying insurers is in the best interest of poor and minority Americans," but"it is a misleading, untruthful strategy to keep the over payments to Medicare private health plans flowing" (Phillips, CQ Health Beat, 9/7).

Staff reductions: One-third of physicians would reduce clinical staff levels without a reversal of a 10% reduction in Medicare reimbursements scheduled for next year, and 9% would reduce the number of physicians in their practices, according to a recent survey conducted by the Medical Group Management Association, CQ Health Beat reports. In addition, 57% of physicians would reduce health benefits for staff, and 44% would reduce administrative staff levels, the survey found. The survey also found that more than 41% of physicians could decide to limit the number of Medicare beneficiaries they treat and that 19% would not accept beneficiaries as new patients (Carey, CQ Health Beat, 9/7).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives. The Kaiser Weekly Health Disparities Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.