Medicare + Choice: HCFA Actions Could Improve Plan Benefit and Appeal211 Information. Statement of William J. Scanlon, Director Health Financing and 211 Public Health Issues, Health, Education, and Human Services Division

摘要

The importance of plan information will grow as the Medicare+Choice program,211u001ecreated by the Balanced Budget Act (BBA), generates an expanded array of health 211u001eplan alternatives to the traditional fee-for-service arrangement and attracts 211u001emore and more beneficiaries to those options. In just the last 3 years, Medicare 211u001emanaged care enrollment has nearly doubled. Approximately 7 million of Medicare's 211u001e39 million beneficiaries (more than 17 percent) are currently enrolled in managed 211u001ecare plans. Informed choices will be particularly important as BBA phases out the 211u001eopportunity for beneficiaries to disenroll from a plan on a monthly basis and 211u001emoves toward the private sector practice of annual reconsideration of plan 211u001echoice. My comments today will focus on (1) the accuracy, completeness, and 211u001eusefulness of the information Medicare managed care organizations (MCOs) 211u001edistribute about their plans' benefit packages; (2) the extent to which MCOs 211u001einform beneficiaries of their plan appeal rights and the appeals process; and (3) 211u001eHCFA's review, approval, and oversight of the plan information that MCOs 211u001edistribute.