The medical sector and the government ask CMS to correct the Medicare Advantage rate gap

A broad coalition of Puerto Rico's health sector, made up of the Colegio de Médicos Cirujanos chaired by Carlos Díaz Vélez, the Hospital Association led by Jaime Plá Cortés, and the Puerto Rico Association of Insurance Companies (ACODESE), filed a formal petition with the Centers for Medicare & Medicaid Services (CMS) in Washington.

The technical ask demands that the federal agency review the Advance Rate Notice methodology to correct the structural rate gap in the Medicare Advantage program. In Puerto Rico, where more than 650,000 older adults and people with disabilities are enrolled in MA plans, the base reimbursement rate per patient per month is approximately 40 percent below that of the lowest-income state in the United States and 21 percent lower than in the U.S. Virgin Islands.

The resident commissioner in Washington, Pablo José Hernández Rivera, and Governor Jenniffer González Colón backed the common front, noting that the disparity imposed by CMS financially chokes community hospitals and speeds the exodus of specialist physicians to states such as Florida and Texas, leaving the island's patients with wait lists of months for critical appointments.

Source: El Vocero. https://www.elvocero.com/gobierno/sector-salud-reclama-a-cms-corregir-brecha-tarifaria-en-medicare-advantage/article_73cmsmedicare.html