tci Medicare Compliance & Reimbursement - 2003 Issue 28

HealthPlans: HEALTH PLANS SAY REFORM BILLS WILL CONSTRAIN MARKET

The administration has put its weight behind a Medicare private-plan structure that would offer comprehensive coverage through three preferred provider plans per region. The provision might be expected to please proponents of a private-market transformation for Medicare. However, a surprising number of Republicans and insurance-industry representatives criticize the White House's favored setup. Because the mechanism would permit only a limited number of the lowest-bidding health plans to enter Medicare, it would in fact constrain market forces and forfeit much of the value of health-plan competitive bidding, critics say. But according to Centers for Medicare & Medicaid Services Administrator Tom...

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