The American Hospital Association (AHA) has raised concerns with a Homeland Security Subcommittee about potential access restrictions by Medicare Advantage (MA) plans. The AHA is urging increased congressional oversight of these plans, prioritizing prompt patient access, consumer protection, and enforcement of new Medicare rules. Diverse stakeholders testified at the hearing.
On May 17, the American Hospital Association (AHA) expressed its concerns to the Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations about the alleged limitations some Medicare Advantage (MA) plans place on beneficiary access to necessary covered services. The AHA encouraged Congress to intensify its supervision of these plans.
AHA stated in a submission to the subcommittee that issues related to the utilization and coverage policies of MA plans have become so significant and persistent that immediate and decisive enforcement measures are essential to safeguarding the well-being of elderly and ill patients, their caregivers, and American taxpayers. Taxpayers pay more to MA plans for administering Medicare benefits to enrollees than they do for the traditional Medicare program, according to the AHA.
In its recommendations, the AHA insisted that Congress should command more supervision over the MA program to ensure prompt patient access, consumer protection, and proper enforcement of the recent rules from the Centers for Medicare & Medicaid Services. These rules aim to better harmonize MA coverage policies with traditional Medicare. AHA also proposed increasing data collection on plan performance and facilitating ways to report suspected breaches of federal rules.
The hearing saw testimonies from various stakeholders, including the widow of an MA enrollee and representatives from the Department of Health and Human Services Office of Inspector General, the Kaiser Family Foundation, the Greater Wisconsin Agency on Aging Resources, and Marquette University College of Nursing.
