Puerto Rico Calls on HHS-CMS to Address Equity Issues in Medicare Advantage Program
A coalition of Puerto Rican health care members recently sent a letter to the Health and Human Services Secretary Xavier Becerra and Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure, requesting equity in the Medicare Advantage program.
“Seniors in Puerto Rico are poorer and have more chronic conditions than the MA population in the states, and yet federal payments for these seniors continue to fall significantly relative to the states,” write members in the letter.
The coalition requests that HHS-CMS adopt crucial administrative policies to alleviate current inequities in the operation of the MA program.
Currently, about 3.2 million American citizens on the island are Medicare beneficiaries who receive benefits through the MA program.
The letter argues that the current MA rate-setting formula has caused rates to be severely underestimated for Puerto Rico, with those rates 24% below the national average in 2011, and 42% below the national average as of this year.
By comparison, that is 37% below the lowest state, Hawaii, and 23% below the next-lowest jurisdiction, the U.S. Virgin Islands.
The lack of adequate funding is exacerbated by Puerto Rico’s struggle to navigate hurricanes, earthquakes and the global pandemic.
In 2020, the Biden administration released the Biden-Harris Plan for Recovery, Renewal & Respect for Puerto Rico.
The plan indicated the administration would “address historically low Medicare Advantage payment rates and their consequences to Puerto Rico’s health systems.”
So far, no actions have been taken to address the issues outlined in the letter.
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