The U.S. House Ways & Means subcommittees on Health and Oversight held a joint hearing on July 22 entitled “Medicare Advantage: Past Lessons, Present Insights, Future Opportunities.” The hearing included five in-person witnesses including Dr. David A. Basel of Avera Health, who represented a rural and system provider perspective, as well as Dr. Sachin Jain, M.D., M.B.A., CEO of health plan Senior Care Action Network (SCAN).

In written testimony submitted to the committee August 5, LeadingAge aimed to supplement what the committee members heard during the hearing by sharing our skilled nursing facility and home health agency provider members’ experiences from participation in Medicare Advantage (MA) plans.

Our remarks reiterate a longstanding point: the need for MA reforms that address both the inadequate provider payments from MA plans as well as the excessive administrative burden of participating in the program. During the hearing, committee members referenced several pieces of legislation that have been introduced to address needed MA reforms. LeadingAge reiterated our support for the Improving Seniors’ Timely Access to Care Act (H.R. 3513/S.1816), which seeks to standardize and modernize MA prior authorization practices and enjoys broad bipartisan support from more than 200 senators and representatives; and the more recently-introduced, bipartisan Prompt and Fair Pay Act (H.R. 4559), which would require MA plans to pay providers at least Medicare fee-for-service rates and establishes timelines by which they need to pay providers’ clean claims.

We also detailed our concerns about aspects of Congressman David Schweikert’s (R-AZ) MA reform bill, H.R. 3467 that would seek to automatically enroll all Medicare A and B eligible beneficiaries into an MA plan and lock them into that specific plan for 3 years. Should such an MA auto-enrollment provision pass Congress, it could lead to a rapid shift of the remaining Medicare beneficiaries into MA and could be financially perilous for providers.

Members can read our written testimony as we submitted here.