Contact: Aaron White
La Crosse – Today, U.S. Rep. Ron Kind introduced the bipartisan Medicare Advantage Quality Payment Relief Act, which would reward high-performing Medicare Advantage health plans and lower premiums for Wisconsin seniors. The bill was introduced with Reps. Mike Doyle (D-PA), Mike Kelly (R-PA) and Brett Guthrie (R-KY).
“Older Wisconsinites deserve the best quality coverage and care we can provide. I am proud to work together to introduce this bipartisan fix to ensure Medicare Advantage beneficiaries have access to high-quality, affordable health care plan options,” said Rep. Ron Kind.
In order to improve quality for American seniors enrolled in Medicare Advantage plans, Congress created a quality incentive payment program designed to reward high-performing plans for providing high-quality care. Unfortunately the Department of Health and Human Services (HHS) has subjected quality bonus payments to a payment “benchmark cap.” This glitch in how HHS has interpreted the benchmark cap cuts off the full quality incentive payments to the highest quality 4- and 5-star health plans. In 2018, high-performing plans missed out on over $800 million in quality bonus payments which are required to be returned to enrollees in the form of lower premiums or enhanced benefits.
Wisconsin seniors have lost out on $51 million of reduced premiums or increased services in 2018 alone. According to estimates from the Congressional Budget Office, $180 million in quality incentive loss is predicted in Wisconsin over the next three years. On a county-by-county level, western and northern Wisconsin are disproportionally impacted by this issue. Security Health Plan, part of the Marshfield Clinic Health System in Wisconsin, could reduce their Medicare Advantage premium by $25 per month for Wisconsin beneficiaries if the bill were enacted.
The bipartisan Medicare Advantage Quality Payment Relief Act is supported by many impacted organizations and patient advocacy groups, including Marshfield Clinic Health System in Wisconsin:
“Fixing the benchmark cap is the right thing to do,” stated Julie Brussow, CEO of Security Health Plan, part of the Marshfield Clinic Health System in Wisconsin. “Representative Kind’s proposal is a responsible and common-sense solution that removes an unfair penalty against innovative and high-performing health plans like Security Health, and many others across the country. Most importantly, Rep. Kind’s proposal will drive down the cost that seniors have to pay in the Medicare Advantage plans, especially in rural areas. In fact, we estimate our plan enrollees could see an average premium reduction of up to 20% with this bill. We are hopeful that Congress will move this important legislation forward, and help reduce the cost of Medicare Advantage for seniors.”
Wisconsinites with questions about their Medicare plan can call Rep. Ron Kind’s office toll-free: 1-888-442-8040, or visit kind.house.gov.