Seniors Told to Lobby Against Cuts of Payments to Insurers

WHEELING – Senior citizens who use Medicare Advantage health plans are being urged by an organization to tell their legislators not to allow the Centers for Medicare and Medicaid to cut payments to insurers.

During a breakfast gathering at Perkins Restaurant & Bakery in Wheeling, Tom Susman, a health care consultant working with the Coalition for Medicare Choices, said the coalition wants people to call Sen. Joe Manchin, D-W.Va., and Rep. David McKinley, R-W.Va., before the CMS sets the final payments rates for Medicare Advantage on April 7.

Preliminary rates for 2015 from CMS are expected to be announced Feb. 21.

Susman said recent cuts to the plan have resulted in insurance companies passing on the costs to its customers, resulting in additional out-of-pocket costs of $30 to $70.

“Recent cuts to Medicare Advantage have put at risk the coverage millions of seniors like and rely on today. The health care reform law includes more than $200 million in payment cuts, the vast majority of which have not gone into effect yet, and imposes a new health insurance tax that begins this year,” Susman said.

“These funding reductions combined with other changes to the program resulted in payment cuts of 6.5 percent in 2014. These were real cuts in payments – not reductions in rates of projected growth,” he added.

Susman said Medicare Advantage is health insurance offered by private insurance companies, but the government pays a certain amount per month person to the insurance companies. He noted many state Public Employees Insurance Agency members also use the Advantage Plan. New payment cuts would occur October 2014 during enrollment for 2015 Medicare Advantage coverage.

“Some in Washington will say, ‘Well, these are cuts on insurance companies.’ They’re not because these cuts get passed down to you all,” he said.

Susman is president of TSG Consulting in Charleston. He was appointed as director of the West Virginia PEIA when Bob Wise was governor.