The Joplin Globe, Joplin, MO

National News

April 23, 2012

Nonpartisan gov’t auditors rebuke Medicare bonuses

WASHINGTON — In a blow to the Obama administration on Medicare, government auditors Monday called for the cancellation of a costly bonus program for private health plans that congressional Republicans have criticized as a wasteful political ploy.

The nonpartisan Government Accountability Office said it’s not clear that the $8.3 billion Medicare Advantage bonus program will improve quality because most of the money is going to plans just rated average. The auditors did find, however, that the bonuses would temporarily ease the pain of unpopular cuts to insurance plans under President Barack Obama’s health care overhaul law.

Ahead of presidential and congressional elections in which seniors are a key group of swing voters, the administration has been working hard to portray itself as a good steward of Medicare, by cracking down on waste and fraud, improving benefits, and keeping costs under control. The GAO report could become a blemish on its record.

The administration defended the program, saying without bonuses many plans would not have an incentive to improve.  

But Sen. Orrin Hatch, R-Utah, said the GAO report suggests that the administration abused its authority, pumping money to the plans to avoid more criticism over the cuts.

Medicare Advantage is a popular private insurance alternative to the traditional health care program. More than 3,000 private plans serve nearly 12 million beneficiaries, about one-fourth of Medicare recipients. They offer lower out-of-pocket costs, usually in exchange for some limitations on choice.

The health care law trimmed Medicare Advantage to compensate for prior years of overpayments that had allowed the plans to offer attractive benefits — and pocket healthy profits.

Republicans fiercely attacked those cuts during their successful campaign to take control of the House in the 2010 midterm elections. Seniors responded by backing GOP candidates.

After the election, the administration announced what it called a “demonstration program” to test whether a generous bonus program would lead to faster, broader improvements in quality. (The health care overhaul law had already provided a smaller bonus program only for top-rated plans.)

GAO, the investigative agency of Congress, did not address GOP allegations that the bonuses are politically motivated. But, its report found the program highly unusual. It “dwarfs” all other Medicare pilots undertaken in nearly 20 years, the GAO said.

Most of the bonus money is going to plans that receive three to three-and-half stars out of a possible five stars on Medicare’s quality rating scale, the report said.

Available through 2014, the bonuses will soften much of the initial impact of the Medicare Advantage cuts, acting like a temporary reprieve.

This year, for example, the bonus program offset about 70 percent of the cuts in the health care law. Indeed, Medicare Advantage enrollment is up by 10 percent and premiums have gone down on average.

But GAO questioned whether the bonus program will achieve its goal of finding better incentives to promote quality. “The design of the demonstration precludes a credible evaluation of its effectiveness in achieving (the administration’s) stated research goal.”

The administration says it disagrees with the GAO findings and believes the bonuses will improve the quality of care.

“Absent this demonstration, we believe that many plans would not have an immediate incentive to improve the quality of care delivered to (Medicare Advantage) enrollees,” the Health and Human Services department said in its formal response to GAO.

Hatch, the ranking Republican on the Senate panel that oversees Medicare, is questioning whether the administration had the legal authority to create the program.

“The Obama administration seems to be using a technicality to sidestep Congress and write itself a blank check to spend more money for political purposes leading into this year’s elections,” said Hatch.

“The White House does not have the authority to green-light spending on whatever program it wants,” he added. “This report is just the beginning — I will be demanding answers.”

HHS Secretary Kathleen Sebelius said overpayments to the private plans are coming down, even with the bonus program. “Even with the demonstration, we are on track to reduce overpayments,” she said.

The Associated Press first reported on concerns about the bonus program last spring. Administration officials said at the time it had nothing to do with politics.

But another nonpartisan agency that advises lawmakers on Medicare also criticized the bonus plan as the administration was pursuing it.

The Medicare Payment Advisory Commission said it amounts to “a mechanism to increase payments” and its design “sends the wrong message about what is important to the program and how improved quality can best be achieved.”

The bonuses are the costliest demonstration program in Medicare history. They’ll be paid from the Medicare trust fund.

 

1
Text Only
National News
  • Salmonella decline seen in food poisoning report

    The government’s latest report card on food poisoning shows a dip in salmonella cases but an increase in illnesses from bacteria in raw shellfish.

    April 18, 2014

  • Judge in gay marriage case asks pointed questions

    A judge in Colorado who will play a pivotal role deciding whether gays should be allowed to wed in the United States asked pointed questions Thursday about whether Oklahoma can legally ban the unions.

    April 17, 2014

  • Obama shows skepticism on Russia in Ukraine

    President Barack Obama conveyed skepticism Thursday about Russian promises to de-escalate a volatile situation in Ukraine, and said the United State and its allies are ready to impose fresh sanctions if Moscow doesn’t make good on its commitments.

    April 17, 2014

  • Cyber cops: Target hackers may take years to find

    Secret Service investigators say they are close to gaining a full understanding of the methods hackers used to breach Target’s computer systems last December.

    April 17, 2014

  • Court to weigh challenge to ban on campaign lies

    As political campaigns begin to heat up, the Supreme Court is deciding whether false accusations and mudslinging made during an election can be punished as a crime.

    April 16, 2014

  • Auto Show Nissan Hot _Cast.jpg Hot models at this year’s New York Auto Show

    With more than 1 million visitors annually, the New York International Auto Show is one of the most important shows for the U.S. auto industry.

    April 16, 2014 3 Photos

  • Transportation Blues 2.jpg Congress is giving states the transportation blues

    On the road in a tour bus this week, the U.S. transportation secretary is spreading some bad news: the government’s Highway Trust Fund is nearly broke.

    April 15, 2014 2 Photos

  • Report: Russia withheld intel before Boston attack

    A yearlong review of information the U.S. intelligence community had prior to the Boston Marathon bombing found that the investigation could have been more thorough.

    April 11, 2014

  • Obama Health Secretary.jpg Obama announces Sebelius resignation, successor

    President Barack Obama praised outgoing Health and Human Secretary Kathleen Sebelius for helping to steer his health care law’s comeback after a rocky rollout, even as he nominated a successor aimed at helping the White House move past the political damage.

    April 11, 2014 1 Photo

  • Police seek driver in deadly Florida day care crash

    As mourners trickled by Thursday to honor the 4-year-old girl who was killed and 14 others injured in a crash at a Florida day care, authorities scoured the state for the driver they said fled in the vehicle that caused the fatal wreck.

    April 10, 2014

Facebook
Poll

A Missouri Senate committee has endorsed a 1-cent sales tax increase to fund transportation projects. The proposed constitutional amendment passed the House earlier this month. If passed by the full Senate, the measure would head to the November ballot for voter approval. Would you vote in favor of it?

Yes.
No.
     View Results
Parade
Magazine

Click HERE to read all your Parade favorites including Hollywood Wire, Celebrity interviews and photo galleries, Food recipes and cooking tips, Games and lots more.
NDN Video
Captain of Sunken SKorean Ferry Arrested Raw: Fire Destroys 3 N.J. Beachfront Homes Raw: Pope Presides Over Good Friday Mass Raw: Space X Launches to Space Station Superheroes Descend on Capitol Mall Man Charged in Kansas City Highway Shootings Obama Awards Navy Football Trophy Anti-semitic Leaflets Posted in Eastern Ukraine Raw: Magnitude-7.2 Earthquake Shakes Mexico City Ceremony at MIT Remembers One of Boston's Finest Raw: Students Hurt in Colo. School Bus Crash Raw: Church Tries for Record With Chalk Jesus Raw: Faithful Celebrate Good Friday Worldwide Deadly Avalanche Sweeps Slopes of Mount Everest Police Arrest Suspect in Highway Shootings Drought Concerns May Hurt Lake Tourism Vermont Goat Meat Gives Refugees Taste of Home Calif. Investigators Re-construct Fatal Bus Cras Mayor Rob Ford Launches Re-election Campaign Appellate Court Hears Okla. Gay Marriage Case