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Draft House bill for health care reform would revise the Medicare advantage program.

Article Excerpt
On June 19, 2009, Democrats from three key committees of the U.S. House of Representatives revealed their draft plan for health reform, which would require most individuals to obtain health insurance and would create a national health insurance exchange through which qualifying individuals and employers could obtain health insurance. The draft bill (the House Bill) also would modify the MA Program in several significant ways, if enacted. Select proposals include the following:

Modifying Benchmarks and Payment Rates Beginning in 2011, the benchmark upon which MA Plan payment rates are calculated would be gradually reduced to reflect average per capita costs under traditional Medicare fee-for-service (Medicare FFS) for the applicable service area.

The House Bill differs from the adjustments proposed by the Obama administration in its CY 2010 budget and by the Senate Finance Committee in its April 2009 white paper on Medicare reform (White Paper). Those proposals, as described during the May 2009 Forum call, include implementing an across-the-board downward adjustment (e.g., 1 percent) of all MA benchmarks in 2011 and targeted adjustments in future years; adjusting benchmarks to reflect a blend of national and local per capita costs for Medicare FFS; or modifying benchmarks to reflect the enrollment-weighted average bid for each service area.

The Senate Finance Committee has not yet released its draft health reform bill, so it is not clear what modification to...

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