Governor Pedro Pierluisi Creates Multisectoral Task Force to Demand Equal Treatment in Medicaid and Medicare Funding
Tuesday, March 30, 2021 - 3:42 p.m.
By ELNUEVODIA.COM
The temporary nature of the allocation of funds Medicaid and Medicare that ends on Sept. 30, 2021 keeps the government of Puerto Rico and the vital health coverage of thousands of Puerto Ricans at potential risk of a "fiscal abyss," said Gov. Pedro Pierluisi.
"There is no doubt that the economic crisis, the devastation caused by the passage of Hurricanes Irma and Maria, and the HIV/AIDS pandemic have affected the health system infrastructure and caused an exodus of health care providers. COVID-19 have affected the infrastructure of the health care system and caused an exodus of health care providers. If the flow of federal funds to Puerto Rico decreases, Puerto Rican patients will have fewer benefits and the government will not have sufficient resources to provide adequate health care services. This will also impact providers," the governor said in a statement.
Given this fiscal reality and the "urgent need to achieve equal treatment" in funding for the federal Medicaid and Medicare programs, to prevent thousands of Puerto Ricans from being left without health care coverage starting in October of this year, the President created today through Executive Order 2021-025 a Multisectoral Working Group that will prepare proposals and strategies before Congress and the federal Executive Branch.https://2e6b9ab0d157dc493d6797b9c10b134f.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html
The multi-sectoral group, which will be chaired by Health Secretary-designate Carlos Mellado and co-chaired by the executive director of the Federal Affairs Administration (PRFAA), Carmen Feliciano, will work in coordination with the governor and key components of the health sector. It will also be composed of the resident commissioner in Washington, D.C., Jennifer González Colón, ASES executive director Jorge Galva, the governor and key components of the health sector.Health Insurance Administration(ASES) Jorge Galva, and the executive director of the Authority for Financial Advisory and Fiscal Agency (AAFAF), Omar Marrero.
In the Executive Order, Pierluisi argues that Puerto Rico, as a U.S. territory, does not receive parity in federal funding for the Medicaid and Medicare health programs, as compared to the states and the District of Columbia.
In the case of Medicaid, states receive federal funds at a federal rate called the Federal Medical Assistance Percentage (FMAP) that varies according to state per capita income. "However, the federal funds Puerto Rico receives are significantly less, with a cap and a fixed rate, which is lower than the rate it would receive if it were a state," he said.
"This inequity in federal funds causes the Puerto Rico government to have to defray a large part of the cost of the Government Health Plan known as the Vital Plan with state funds," Pierluisi said.
According to La Fortaleza, with the passage of the Further Consolidated Appropriations Act (PL 116-94), Congress granted a temporary increase in the Medicaid funding cap for the Vital Plan of $2,623,188,000 for federal fiscal year 2020 and $2,719,072,000 for fiscal year 2021. This represents an increase of $95,884,000. On the other hand, through the Families First Coronavirus Response Act (PL 116-27), the Medicaid funding cap was temporarily increased to $2,716,188,000 for FY 2020 and $2,809,063,000 for FY 2021 for a difference of $92,875,000.
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"However, currently, thousands of Puerto Ricans who would be eligible for Medicaid benefits in any state because of their income, do not qualify for such benefits due to the existing inequity in the Poverty Level Ratio that the federal government applies to Puerto Rico," said the chief executive.
According to the Executive Order, there are critical measures that have been worked on to increase Medicaid program eligibility, benefit improvements and provider compensation (physicians and hospitals), but the temporary nature of this appropriation, which ends on September 30, 2021, has the effect of placing Puerto Rico once again at the potential risk of a fiscal cliff in Medicaid funding for fiscal year 2022, which begins on October 1, 2021, and for subsequent years. As a result, thousands of Puerto Ricans could lose their health coverage.
The Multisectoral Working Group must submit an initial report to the governor in 30 days on possible strategies to impact federal public policy and achieve parity in Medicaid and Medicare funding. Pierluisi said that if Puerto Rico is to receive a "fair and equitable treatment" in Medicaid, it is "imperative" that new benefits be added to the coverage.
The Hospital Association, the Puerto Rico College of Surgeons, the Puerto Rico Medicaid & Medicare Advantage Products Association (MMAPA), the Independent Practice Association (IPA) and the Community Pharmacy Association will also be part of the Group. There will also be three additional members appointed by Pierluisi.