House Ways and Means Health Subcommittee Chairman Pete Stark (D-Calif.) has introduced legislation to prevent Medicare Advantage plans from charging seniors and people with disabilities more than they would pay a traditional fee-for-service Medicare for any service.
Stark said that MA plans have charged more than traditional Medicare for services ranging from home health care, hospital stays and chemotherapy drugs to durable medical equipment. The Medicare Advantage Truth in Advertising Act (HR 2945) would continue to permit flat co-payments - which private plans charge for certain benefits or services in lieu of deductibles or co-insurance in traditional Medicare. However, those charges could never exceed Medicare's charges.
Barbara Kennelly, president of the National Committee to Preserve Social Security and Medicare, said that private plans may create financial barriers to care by imposing higher cost-sharing requirements for benefits that protect the sickest and most vulnerable beneficiaries.
According to Stark’s office, MA agents have used illegal sales tactics, including lying about MA premiums and physician participation in private plans, to take advantage of beneficiaries. The sales agents have used these tactics on individuals with serious language barriers or cognitive impairments and enrolled beneficiaries who thought they were signing up for new Medigap plans. Use of these tactics on such vulnerable beneficiaries make the bill even more important, Stark's staff said.
Bill Vaughan, senior policy analyst at Consumers Union, said MA plans, particularly private fee-for-service plans, have confusing arrays of co-payments and deductibles. Some beneficiaries reportedly have joined such plans without understanding their out-of-pocket expenses may actually be higher compared to traditional Medicare, he said.
Source: CCH Washington Bureau, June 29, 2007.
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