March 31, 2020
Seema Verma, MPH Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
200 Independence Avenue, SW, Room 445-G
Washington, DC 20201
Dear Administrator Verma:
Thank you for all the work you are doing with regard to the nation’s response to the COVID-19 pandemic. These are trying times for us all and we are grateful for your strong leadership.
As you know well, the COVID-19 pandemic presents particular risk for certain vulnerable populations, particularly seniors. I am writing today to ask that in the Medicare Advantage 2021 Rate Setting that CMS is careful not to compound the impact of this virus.
Medicare Advantage is a highly popular, affordable and growing choice for many seniors. They have come to rely on it for the high-quality coordinated care and predictability that it offers. The 2021 payment and policy setting process is based on the experience of primarily the prior year and makes certain determinations about future funding; however, this year is like no other.
We know from our own experience and from that of our members that seniors are putting off preventive care and rescheduling elective surgeries. Physicians’ offices are closing down, often only accessible via telehealth. These unique circumstances will undoubtedly affect risk adjustment calculations and Star Ratings, which could have unintended and harmful consequences for seniors in coming years if CMS does not appropriately account for COVID-19 in the 2021 Medicare Advantage Final Notice.
We also know that there is no way for Medicare Advantage plans to accurately forecast the cost of treatment for COVID-19 patients, now or next year. This is an extraordinary event that must be addressed in an extraordinary manner.
Unless COVID-19 is appropriately factored in for 2021, seniors could learn about higher costs and reduced benefits in mid-October 2020 when Medicare open enrollment starts.
On behalf of more than twenty-four million Medicare Advantage enrollees, we ask that you give special attention to the 2021 Rate Setting to ensure that seniors are not made doubly vulnerable as a result of COVID-19.
Please don’t hesitate to contact us if we can provide any further information.
James L. Martin
Saulius “Saul” Anuzis