Boston—Minuteman Health recently submitted comments in response to the Centers for Medicare & Medicaid Services 2018 Notice of Benefit and Payment Parameters. The company called for CMS to take immediate action to correct the significant unintended consequences of the Affordable Care Act in order to stabilize the market and ensure that consumers have access to affordable health care options.
“The ACA has expanded coverage for millions of Americans and removed barriers to care such as pre-existing condition exclusions,” said CEO Thomas Policelli. “However, other ACA-related reforms have destabilized the market, which has led to increasing premiums, issuers fleeing the market, fewer affordable options for consumers, and the collapse of other carriers. Our comments provide solutions to mitigate these issues.”
Minuteman submitted comments on a broad range of issues, including the much-criticized federal Risk Adjustment program. Minuteman noted that the proposed CMS rules do nothing to change the fact that the Risk Adjustment program penalizes affordable health plans while higher cost plans are rewarded, and that health plans that offer affordable Bronze products to price-sensitive consumers are unfairly harmed. The changes proposed by CMS are “too little and too late” and do not address these and other important issues, the company said.
Minuteman in July filed a lawsuit in Boston federal district court against U.S. Health and Human Services (HHS) Secretary Sylvia Burwell, CMS administrator Andrew Slavitt and their respective agencies, claiming that the Risk Adjustment program has illegally cost Minuteman and its members millions of dollars.
Minuteman also commented on market stability issues such as Medical Loss Ratio rules that penalize newer, more affordable health plans, and special enrollment rules that can expose health care plans to fraudulent charges.
As part of its effort to bring attention to inequities in the RA policy, Minuteman founded CHOICES, a national coalition of health care plans organized to work with federal and state regulators on ideas for improving current Risk Adjustment formula. The recently released results of the 2015 Risk Adjustment program underscore CHOICES’ concern that the Risk Adjustment program destabilizes the insurance market.
Minuteman Health, Inc. is non-profit health maintenance organization (HMO) committed to removing inefficiencies from today’s health insurance system to provide high-quality care, cut administrative costs and reduce premiums for individuals and businesses in Massachusetts and New Hampshire.
Minuteman Health’s In-Plan Provider network includes over 11,300 hospitals, physicians, and specialists who provide high quality care at lower costs in Massachusetts and New Hampshire. Updates on Minuteman Health’s evolving provider network can be found at www.minutemanhealth.org.
Minuteman is marketed in Massachusetts through its website, brokers, Health Services Administrators (www.HSAinsurance.com) and the Massachusetts Health Connector. It is marketing in New Hampshire through its website, brokers, and the Federal Healthcare Exchange.
CHOICES members are non-profit as well as investor-owned, health system-sponsored and independent, and newer entrants as well as companies with decades of experience as members of their local communities. The group came together to examine what gaps may exist between the policy intent and the practical reality of the ‘3Rs’ programs today. Such gaps are to be expected in any launch of a new methodology, and CHOICES looks forward to continuing to work productively with CMS to replace old assumptions with the current data.
CHOICES founding members include Minuteman Health, Health New England (Massachusetts), HealthyCT (Connecticut), Land of Lincoln (Illiniois), Melody Health Care (Colorado), New Mexico Health Connections, Evergreen Health (Maryland), Bright Health Plans (Minnesota), Cox Health Plans (Missouri), Medical Associates Health Plans (Iowa), and the National Alliance of State Health CO-OPS (NASHCO).
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