May 23rd, 2016 | By: Bob Herman
A new bill making the rounds on Capitol Hill has a hospital-centric theme. But private Medicare Advantage insurers with bad quality ratings would also benefit from one surreptitious provision.
Last week, Reps. Pat Tiberi (R-Ohio) and Jim McDermott (D-Wash.) introduced the Helping Hospitals Improve Patient Care Act of 2016. A key component of the legislation would take into account socio-economic factors into Medicare readmission rates for hospitals.
That section would delay for three years the CMS’ authority in terminating Medicare Advantage contracts for plans with bottom-of-the-barrel quality scores. In Medicare Advantage, the HMO version of traditional Medicare that hasexploded with enrollment growth over the past several years, the CMS has the authority to discontinue a plan’s contract if the plan fails to garner at least three stars just once in three consecutive years. Continue to read here.