The Bush administration–supported by insurance underwriters–on Sept. 11 signaled a hard line against allowing state insurance regulators a greater role in overseeing the Medicare Advantage program.
" … the collaborative work between the Centers for Medicare and Medicaid Services and the states is critical to the management of an effective program and to protect the beneficiaries," said Abby Block, director of the Center for Beneficiary Choices at CMS, which oversees the MA program.
"At the same time, I must underscore the importance of maintaining oversight of Medicare managed care programs by the federal government," she said. "State regulation of these plans is neither appropriate nor feasible."
The administration's policy is based on the fact that unlike Medigap and Medicare, programs in which states play a large role, MA "is managed and almost entirely subsidized by the federal government.
"Some have likened MA to Medigap plans when suggesting that states assume enforcement authority," she testified.
But, she said, "These are inappropriate comparisons. Medigap plans are paid for entirely by the individual purchaser and supplement Medicare.
"Medicare Advantage plans instead provide all original Medicare benefits, and in some cases additional benefits, and paid for substantially or totally by the federal government," she explained.
Her comments were made at a public hearing in Washington that represented the first meeting of a new National Association of Insurance Commissioners' subgroup on Medicare Private Plans.
But her comments also made clear that the Bush administration and the healthcare industry would also oppose inclusion in final legislation of language now contained in the House version of legislation reauthorizing and expanding the State Children's Health Insurance Plan that mandates a greater role in overseeing MA programs by the states.
One provision of the bill, the Children's Health & Medicare Protection Act, H.R. 3162, (the CHAMP Act) calls for joint federal/state oversight of plan marketing and advertising practices for MA programs.
It also "specifically repeals the federal pre-emption of state law with respect to the marketing and enrollment standards" of MA programs adopted in the so-called CHAMP Act.
In its comments at the hearing, officials of America's Health Insurance Plans, Washington, voiced support for continued federal oversight.
