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Roadmap for Medicare's Future Released on Medicare's 43rd Anniversary
Wednesday, July 30, 2008
Leadership Council of Aging
Organizations
Edward F. Coyle,
Chair
815 16th Street, N.W., 4th Floor
North, Washington, DC
20006
(202)
637-5399 (phone)
(202) 637-5398
(Fax)
http://www.lcao.org/
For Immediate Release: July 30,
2008
Comprehensive Roadmap for
Medicare Released
Coalition Looks to Future of
Medicare as
Program Celebrates its 43rd
Anniversary
Washington, DC – On
the 43rd anniversary of Medicare, the
Leadership Council of Aging Organizations
(LCAO), representing 56 national senior
membership organizations committed to the
well-being of America’s seniors, is pleased to
announce its recommended guiding principles for
the future of Medicare.
The principles are designed to guide the conversation as Congress pursues the national goal of restoring the promise of Medicare. With the program being increasingly privatized, there is a disturbing trend of seniors in 2008 paying more and getting less, while big drug and insurance companies are making record profits.
Key guidelines in the principles address defined benefits, coverage, affordability, program administration, quality assurance, and financing and sustainability. At the top of LCAO’s agenda is guaranteeing dependable, affordable, quality benefits for all older and disabled Americans, regardless of income or health status.
“Thank you to Congress for recently passing H.R. 6331, the ‘Medicare Improvements for Patients and Providers Act of 2008,’” said Edward F. Coyle, LCAO Chair and Executive Director of the Alliance for Retired Americans. “That legislation has provided us with a springboard to look at what more we can do to keep Medicare strong, to make Medicare all that it has the potential to be.”
On the 43rd anniversary of Medicare, it is important to emphasize how the program has afforded millions of older Americans the opportunity to remain healthy. It has enabled millions more disabled Americans to lead independent lives that would not have been possible otherwise. In order to keep this intergenerational social compact that Medicare be as strong as possible for years to come, LCAO recommends the principles described below.
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Contact: David Blank, 202-637-5275 or dblank@retiredamericans.org
Medicare Principles
Medicare should continue to enforce financially sound provision of uniform, dependable, affordable, quality health care to older and disabled Americans. People of all ages include Medicare in their retirement planning. Strengthening Medicare is wise public policy. The Leadership Council of Aging Organizations (LCAO), and the millions of Americans whom we represent, encourage consideration of the following essential elements of strengthening and protecting Medicare.
Defined
Benefits
· Medicare should
maintain its defined benefit structure,
guaranteeing dependable, affordable, quality
benefits for all older and disabled Americans
regardless of income, health status, or
delivery system.
· Medicare
beneficiaries should be able to receive
prescription drug coverage directly from
traditional Medicare, just as they do other
benefits.
· Medicare Savings Accounts
and the 2010 Medicare Comparative Cost
Adjustment Demonstration Project should be
repealed.
· Medicare should not reduce
access by raising the eligibility age or
means-testing eligibility.
Coverage
· Medicare’s
benefit package should provide access to the
most current and effective medical treatments
and technologies. The Secretary of HHS
should have authority to add coverage for new
benefits as necessary.
· Medicare
should cover geriatric assessment and care
management.
· Medicare’s prescription
drug benefit should provide comprehensive
coverage, including the most current,
effective, and individually appropriate drug
therapies.
· Medicare beneficiaries
should be able to change their prescription
drug plan at any time.
· Medicare’s
prescription drug benefit must keep pace with
the increase in costs.
· The Part D
coverage gap or “donut hole” should be
eliminated.
· If Low Income Subsidy
(LIS) recipients choose zero-premium plans as
their best option, the plans must provide
quality, comprehensive benefits. LIS
recipients should not be required to choose
non-zero-premium plans to obtain adequate drug
coverage.
· Medicare Part C and D plans
should be prohibited from making mid-year
formulary changes.
· The coinsurance
rate for outpatient mental health services
should be no more than 20 percent.
· Medicare Advantage package design
should not discriminate in favor of healthier,
lower-cost beneficiaries.
· Medicare
private fee-for-service plans should have the
same reporting requirements and network
coverage as other Medicare Advantage
plans.
· Medicare should eliminate the
current two-year waiting period for those
receiving Social Security Disability Insurance
(SSDI).
Affordability
· Medicare
should expand and align the Medicare Savings
Programs (MSPs) and the LIS. The asset
eligibility test should be eliminated; the
income eligibility thresholds should be
increased; and the MSPs should be wholly
federally funded.
· The Qualified
Individual (QI) program should be made
permanent.
· All beneficiaries
should be protected from burdensome
out-of-pocket expenses.
· Cost sharing
should be eliminated for all preventive
benefits and services.
· The Secretary
of HHS should be given authority to negotiate
prescription drug
prices.
· Beneficiaries who choose
Medicare Advantage plans should not have higher
cost sharing for high cost and other services
and items than under traditional Medicare.
· The federal government should reduce
the cost of prescription medicines by allowing
the safe importation of FDA-approved drugs from
selected countries.
Program
Administration
· Medicare
should be administered fairly, adequately, and
efficiently. Appropriate funds must be
provided for program administration,
beneficiary education, and outreach, especially
to low-income beneficiaries.
· Medicare
providers must be transparent about their
ownership and operations and accountable at all
levels for the quality of care
delivered.
· Medicare must attack
waste, fraud, and abuse to ensure value for the
program.
· Medicare beneficiaries,
including beneficiaries who have limited
English proficiency and who need access to
alternate accessible formats, should have
access to timely and accurate written and oral
(telephone) information.
· Funding for State Health Insurance
Assistance Programs (SHIPs) and the Aging
Network, which offer unbiased assistance to
Medicare beneficiaries, should be
increased.
Quality
Assurance
· All Medicare
coverage options must meet rigorous standards
for consumer protection and quality of care,
including full and fair appeals.
· Medicare must prevent fraudulent
marketing of Medicare Advantage and Part D
plans.
· The National Association of
Insurance Commissioners should develop
standardized marketing requirements for
Medicare Advantage and prescription drug
plans. State insurance commissioners
should have regulatory authority to ensure
proper enforcement.
· Medicare should
prevent the overuse, underuse, and misuse of
health care services.
· Medicare should
monitor and extend the scope of service and
treatment options to address the needs of
minorities and women. CMS should collect
and publish health disparities data and take
appropriate actions to eliminate such
disparities.
· Medicare quality
assurance systems should address the special
needs of those with cognitive impairment to
capture their experiences with the health care
system.
· CMS should strictly monitor
private Medicare health plans, and take strict
enforcement action against plans that violate
the law, regulations, or contracts.
Financing and
Sustainability
· Medicare’s
fiscal challenges should be addressed as part
of cost containment efforts throughout the
health care system.
· The amount of
general revenues available to fund Medicare
should not be limited. Options for
increasing revenues to support the program
should be considered.
· The Medicare
Payment Advisory Commission (MedPAC)
recommendation to bring payments to private
Medicare Advantage plans in line with
traditional Medicare should be
adopted.
· Care coordination for
individuals with chronic illness, geographic
variations in Medicare spending, the use of
evidence-based health promotion and disease
prevention, and other strategies should all be
examined with a goal of increasing
efficiencies, obtaining savings, and improving
the care provided in the Medicare program.
Approved July 2, 2008