FOR IMMEDIATE RELEASE July 1, 1999

CONTACT: Ray Krauze (202) 225-7931

DEUTSCH AND BILIRAKIS INTRODUCE BILL TO PROTECT "MEDICARE + CHOICE" PROGRAM

     Washington, DC-- Congressman Peter Deutsch (D-FL, 20th) and Congressman Michael Bilirakis (R-FL, 9th) introduced the "Medicare+Choice Risk Adjustment Amendments of 1999." The bill preserves and expands health care choices for Medicare beneficiaries by requiring that the Health Care Financing Administration (HCFA) implement a budget neutral risk adjuster.

     "This legislation is absolutely imperative to ensuring that those beneficiaries enrolled in Medicare+Choice receive adequate coverage for their health care services," Deutsch said. "Millions of seniors rely on the Medicare+Choice program for greater flexibility in meeting their health care needs."

     The Medicare+Choice program was created two years ago as part of the Balanced Budget Act (BBA) of 1997. The program was designed to expand health care choices for Medicare beneficiaries by expanding the types of managed care and other options available to beneficiaries.

     The BBA required government officials to establish a process for "adjusting" Medicare+Choice payments based on the likelihood or the "risk" that enrollees will use health care services. Congress anticipated that this new "risk adjustment" process would award Medicare+Choice plans with higher payments for patients who were ill and lower payments for those patients who were healthy.

     HCFA has proposed to implement a risk adjustment model that is not budget neutral and that would adversely effect those beneficiaries enrolled in the Medicare+Choice program. As a result, payment reductions stemming from the BBA would cause upwards of 175,000 Medicare+Choice enrollees to find other coverage or return to Medicare fee-for-service plan.

     "If we fail to act, beneficiaries enrolled in the Medicare+Choice program are likely to lose some of their benefits and end up paying higher out-of-pocket costs," Deutsch added.

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