MMAPA Calls On HHS Secretary To Include Needed Support For Medicare Advantage In Puerto Rico As Administration Prepares To Review 2022 Rates
October 8, 2020
WASHINGTON, D.C. — The Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA), a non-profit organization composed of leading Medicaid and Medicare Advantage organizations on the island, sent a letter to Health and Human Services Secretary Alex Azar highlighting the unique challenges facing the Medicare Advantage (MA) program in Puerto Rico.
Ahead of the administration’s proposed action on the 2022 MA plan year, MMAPA’s letter reiterates the need to implement essential enhancements to protect and support the stability of the MA program in Puerto Rico. While the Centers for Medicare and Medicaid Services (CMS) have taken significant administrative steps in recent years to respond to disparate MA funding for U.S. citizens in Puerto Rico, MMAPA members are concerned that the gap between Puerto Rico and state average benchmarks continues to widen. The average MA benchmarks for Puerto Rico remain 40% lower than the national average and 36% lower than the average in the lowest state (Hawaii).
MMAPA President Roberto García expressed the urgency in including MMAPA’s recommendations in the 2022 Advanced Notice, saying, “Currently, MMAPA members are working tirelessly to protect those who are most vulnerable to COVID-19: the elderly, low income, and those with chronic conditions. However, the pandemic has unveiled the fragility of our system after decades of underfunding in Medicare, similar to what we saw after Hurricane María. We want to urge HHS and CMS to take further steps forward in closing the MA rate gap in 2022, which will support our providers and over 600,000 Medicare Advantage beneficiaries in Puerto Rico. This is crucial to manage the additional challenge in our efforts to support Americans in Puerto Rico during these unprecedented times.“
It is imperative to address this issue as the MA program is evolving to become the cornerstone of the provision of healthcare services to seniors across the nation, especially poor seniors living on a fixed income. Puerto Rico’s MA penetration rate of over 70%, and 90% when accounting for beneficiaries of both Part A and Part B, is the highest in the nation, positioning the island as a case study of how MA delivers efficient and value-based care through choice and private competition.
“MA plans have been able to ‘do more with less’ to serve beneficiaries in Puerto Rico, implementing value-based compensation and addressing social determinants of health within a population that has the highest proportion of dual eligible beneficiaries in the nation. However, the distance in MA base rates is just too much, and continues to be our biggest barrier to develop the resilient health system that the citizens in PR deserve,” added García.
MMAPA once again stresses the importance of remedying the historic underfunding of Medicare in Puerto Rico and thereby enhancing stability in the local health care system, reducing the rate of provider migration to the mainland, and closing long-existing benefit and infrastructure gaps. MMAPA remains committed to working with Congress and the administration to address these funding inequities and ensure that the U.S. citizens of Puerto Rico receive fair funding for their health care system.
The Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) is a non-profit organization composed of the leading Medicaid and Medicare Advantage organizations in Puerto Rico. Founded in 2009, MMAPA is dedicated to promoting policy solutions to solve Puerto Rico’s health care challenges.
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