- InterNewsService / 27/03/2021 https://www.elvocero.com/gobierno/urge-se-atienda-disparidades-en-programa-de-medicare-advantage/article_539532fe-8f00-11eb-9eb0-030b8b15ee98.html
The resident commissioner in Washington, Jenniffer González Colón, in a letter, asked the recently confirmed secretary of the U.S. Department of Health and Human Services (HHS), Xavier Becerra, to urgently address the situation faced by Puerto Rico due to the disparities in the Medicare Advantage programs.
The letter details the situation in which the Caribbean island finds itself in comparison with the states of the northern nation that benefit from the program.
González Colón noted that Puerto Rico is the jurisdiction with the highest enrollment in the Medicare Advantage program and the highest percentage of people eligible for Medicare and Medicaid.
The resident commissioner in Washington calls for the collaboration of the Biden Administration to put an end to the inequalities of Puerto Rican Medicare beneficiaries and their providers on the island.
The following is a translation of the letter sent to the U.S. Secretary of Health:
Dear Secretary Becerra:
Congratulations on your confirmation as Secretary of the U.S. Department of Health and Human Services. I know of your strong and consistent support for health care equity for American citizens in Puerto Rico from your days in Congress and on the federal House Ways and Means Committee, and I look forward to working with you to ensure that these issues are addressed and resolved once and for all.
As Puerto Rico's only representative in the U.S. Congress, I want to bring one of these inequities to your attention. Over the years, Medicare Advantage (MA) has grown to become a critical health care program for patients and providers in Puerto Rico. Although Puerto Ricans pay the same Medicare payroll taxes as citizens in other states, persistent disparities in federal payments are severely affecting the Medicare program on the island. More than 600,000 seniors in Puerto Rico are covered by MA, representing more than 75% of Medicare beneficiaries on the Island (the highest MA penetration in the nation) and the eighth largest MA population in the United States. This number includes more than 280,000 dually eligible seniors, the most vulnerable population on the island, for whom Medicare funding is essential in light of the considerable limitations of Puerto Rico's Medicaid program.
Unfortunately, the very limited corrective actions implemented by HHS and CMS in recent years have not eliminated the enormous disparities in the MA payment rate level for beneficiaries residing on the island. The fact is that MA rates in Puerto Rico have fallen for 7 consecutive years to a benchmark that is now 40% below the national average, 36% lower than in the lowest state (Hawaii), and even 22% below our neighbors in the U.S. Virgin Islands. Given that the MA program is the primary source of health care for seniors in Puerto Rico, these disparities not only jeopardize adequate access to care, but also put additional fiscal pressure on the island's already struggling economy.
Like you, President (Joe) Biden and Vice President (Kamala) Harris have been strong advocates for health care equity for the people of Puerto Rico. In fact, the Biden-Harris Plan for Recovery, Renewal and Respect for Puerto Rico adopted last year provided, in relevant part, that Pres:
"He will direct the HHS Secretary to propose Medicare reimbursement reforms to address the program's chronic underpayments. Biden will address the historically low Medicare Advantage payment rates and their consequences for Puerto Rico's health care system by directing the HHS Secretary to develop and recommend payment reforms and improvements to the program."
Decades of unequal treatment, coupled with the island's current economic and fiscal crisis, the catastrophic devastation of Hurricanes Irma and Maria, ongoing earthquakes, and the current covid-19 pandemic, have resulted in a health care system with poor quality infrastructure and a huge and unsustainable exodus of health care providers to the U.S. mainland.
As stated in the Biden-Harris Plan for Puerto Rico, HHS has an essential role and responsibility to implement a permanent solution to the historical anomalies in the calculation of MA rates for Puerto Rico. One option I have proposed in the past is that HHS could use its administrative authority to establish a minimum average geographic adjustment of 0.70 due to pending data anomalies in the MA formula.
I look forward to working with you and the Biden Administration to respond to these inequities and implement the President's campaign pledge. The time has come to take the necessary administrative steps to ensure that American citizens in Puerto Rico have access to the same standards of quality health care enjoyed by their fellow citizens in the States and to address the widening gap in both reimbursement and services for Puerto Rico's Medicare beneficiaries and providers.
I wish him all the best in this new and critical assignment he is about to undertake.