Kaiser Daily Health Policy Report - Kaisernetwork.org

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For those looking at Medicare options during open enrollment, you may be interested in this report.

http://www.kaisernetwork.org/daily_reports/rep_hpolicy.cfm#56110

Medicare Advantage private fee-for-service plans can cost beneficiaries more out-of-pocket than the traditional fee-for-service program, according to a recent Government Accountability Office report, CQ HealthBeat reports. House Energy and Commerce Committee Chair Dingell (D-Mich.), incoming committee Chair Henry Waxman (D-Calif.), House Energy and Commerce Health Subcommittee Chair Pallone (D-N.J.), House Ways and Means Committee Chair Rangel (D-N.Y.) and House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) requested the report. According to the Medicare Payment Advisory Commission, in 2008 Medicare paid about 17% more for beneficiaries in private fee-for-services plans than if they were in traditional Medicare fee-for-service plans (Ethridge, CQ HealthBeat, 12/15). According to the report, administrative practices used by PFFS plans can lead to higher costs for Medicare beneficiaries (Edney, CongressDaily, 12/15). PFFS plans can charge Medicare beneficiaries for the full cost of services, whereas the fee-for-service program does not charge beneficiaries the full cost unless health care providers warn that Medicare might not cover the services, the report stated. PFFS plans also do not have to protect Medicare beneficiaries from financial liability, a requirement that Medicare HMOs and PPOs must meet, according to the report. In addition, in the event that Medicare beneficiaries do not inform PFFS plans before they receive services, the plans can require beneficiaries to pay a large share of the cost, a possible violation of federal rules, the report stated.