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This Week in Health Care Reform - March 6th, 2015

The fight to preserve the Medicare Advantage program rages on; the health care law has its day in court…again; 800,000 consumers receive incorrect tax information; and, backend issues persist on the federal exchange.


Week in Review

Medicare Advantage: As expected, two weeks ago, the Centers for Medicare & Medicaid Services (CMS) released its annual Advance Notice proposing changes to how the Medicare Advantage program is funded and administered.  For those following the issue, the efforts to preserve the popular program, which serves nearly one-third of all Medicare beneficiaries, has, by necessity, evolved into a year-long advocacy push involving stakeholders from across the health care spectrum.   Already, physician groups, payers, and even lawmakers have urged CMS to protect the program from further harmful cuts.  While on the surface, the latest proposed changes to Medicare Advantage seem minimal, year-to-year cuts to the program have only resulted in disruption for the 16 million seniors and persons with disabilities enrolled in Medicare Advantage plans and led to the further deterioration of the underlying fabric that makes the program so demonstrably successful in delivering the right care at the right time to the right patients.  Learn more about why Medicare Advantage is worth protecting and how you can add your voice to the efforts to protect it and the millions that depend on its coordinated model of comprehensive care. 

SCOTUS Arguments:
Oral arguments in the King v. Burwell tax subsidy appeal were made before the Supreme Court this past Wednesday.  And, while coverage and analysis were quick, less immediately known was how, exactly, to interpret the Justices’ respective reactions (or lack thereof) to the presented arguments.  With a ruling not expected until late June or early July, thoughts now turn to what could happen in the wake of that decision.

Tax Error:
On the heels of celebrating, what had been touted as, a successful enrollment season, the Administration announced that it had inadvertently sent 800,000 consumers incorrect tax information.  The errors occurred on new forms meant to be used by enrollees to determine subsidy eligibility for their premiums.  The mistake could complicate tax filings for the nearly one million people who received the incorrect information.  In fact, of those 800,000 consumers, 50,000 had already used those forms to file their taxes before the error was caught.  In an effort to contain the damage, the Administration went on to announce that those individuals would not be required to file amended tax returns and that the IRS would not be collecting for any underpayments.

Website Glitches:
Despite consumers enjoying a vastly improved experience during the second open enrollment period, signs point to persistent troubles behind-the-scenes.  Improper “wiring” on the backend of the website continues to afflict the system, some 18 months after it was initially launched.  And, a new report from the nonpartisan Government Accountability Office (GAO) takes CMS, the Agency responsible for the portal, to task.  Their analysis found several problems with the initial development and rollout of the online consumer portal, specifically: Inadequate capacity planning; software coding errors; and, a lack of functionality.  Deficiencies in system testing, in addition to a lack of oversight and poor management of requirements for IT projects, are still evidenced, the report goes on to say, despite CMS implementing new governance processes last summer.

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Looking Ahead

Medicare Advantage beneficiaries and stakeholders continue to fight to protect the program from further, harmful cuts.  You can helpLearn more

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