tci Medicare Compliance & Reimbursement - 2003 Issue 12

Medicare+Choice: BILL OFFERS GOOD NEWS TO M+COS IN SUBURBIA

Medicare+Choice organizations would get a much-needed payment boost under bipartisan legislation proposed by Sens. Charles Schumer (DNY) and Rick Santorum (R-PA). The bill (S. 590) “would fix the chronic underfunding of Medicare+Choice plans by creating a new method of federal HMO reimbursement,” Schumer said a press release. It would adjust upward the three original M+C reimbursement formulas — fee-for-service, per-capita rate and the revised minimum payment increase — and add a “blend component,” which would combine the average of the minimum annual increase and the highest area-specific rate in the region. That would make it...

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