AHCA warns automatic Medicare Advantage enrollment could 'significantly impact' plan sponsors, beneficiaries, providers

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The American Health Care Association/National Center for Assisted Living said proposed changes in Medicare Advantage in 2019 could hurt beneficiaries in a letter to Centers for Medicare & Medicaid Services.

The Jan. 16 letter said AHCA had concerns about “the impact that reducing several areas of regulatory requirements will have on beneficiary safeguards."

Under CMS' proposal for seamless conversion, Medicare's most vulnerable beneficiaries could be automatically enrolled without a chance to actively choose their coverage or determine if a selected health plan is their best option, AHCA/NCAL said.

“Inconsistencies in provider networks may negatively impact beneficiaries' continuity of care,” the association said. ”AHCA/NCAL strongly urges CMS to eliminate all use of seamless conversion to avoid these concerns.”

The letter noted that last year some 19 million, or 33%, of all Medicare beneficiaries enrolled in MA plans versus traditional Medicare fee-for-service. Between 2008 and 2016, MA enrollment has nearly doubled, from 9.7 million to 17.6 million beneficiaries.

On another issue, AHCA/NCAL said it supports the CMS proposal to eschew the requirement for downstream and related entities to take CMS compliance training, saying the move would reduce red tape.

“We are in favor of any action that results in a reduction of the administrative cost burden carried by providers,” AHCA/NCAL said.