Wednesday, August 15, 2018

Resident Commissioner requests better Puerto Rico health provider rates

By on February 14, 2018

Puerto Rico Resident Commissioner Jenniffer González and CMS Administrator Seema Verma (Courtesy)

SAN JUAN – Puerto Rico’s resident commissioner in Washington, D.C., Jenniffer González Colón, met Tuesday with the administrator of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, to express her gratitude for the Trump administration’s support in the unprecedented $4.9 billion allocation for the Medicaid program in Puerto Rico.

The commissioner also requested more resources to improve the rates of healthcare providers in Puerto Rico, which include doctors, laboratories, hospitals and pharmacies, as well as the Medicaid and Medicare Advantage (MA) programs.

“In Puerto Rico, we have over 580,000 seniors who use MA and deserve a health system with doctors, health providers and the resources necessary to respond to their needs, on equal terms with the states. However, the reality is that MA reimbursement rates applicable to Puerto Rico are, on average, the lowest in the nation, 39 percent lower than the state of Hawaii, and even 26 percent lower than those of [the U.S.] Virgin Islands. This payment level is unsustainable and is one of the factors that causes the exodus of health professionals. Given this, I asked the Administration to exercise their administrative authority to achieve progress, to reduce the disparity suffered by Puerto Rico,” the congresswoman said in a written statement.

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The meeting between González and Verma arises as a result of CMS publishing its draft “2019 Medicare Advantage and Part D Advance Notice,” and the approval of the multibillion-dollar allocation for Puerto Rico.

At the meeting, Verma said Puerto Rico could, in its handling of the regular Medicaid program, use the resources allocated to increase payments to health providers in Puerto Rico and make them more flexible.

The Advance Notice of CMS entails a period of public comment that extends until March 5.

“Our seniors continues to increase [in numbers] on the island. Both Medicaid and Medicare Advantage programs represent the healthcare of these patients. CMS has the administrative authority to increase the level of payment reimbursement rates for MA in its next call letter so Puerto Rico is, at least, equal to the levels assigned to the beneficiaries of MA in the [U.S.] Virgin Islands, to mitigate the flight of providers and patients from the healthcare system of Puerto Rico,” González said.

In a letter from CMS to the commissioner, dated Feb. 9, Verma reiterated her willingness to keep the benefits already granted and explore alternatives to provide additional support for Puerto Rico, both administratively and in the search for solutions via congressional action.

“I thank Administrator Verma for her leadership in this important matter for Puerto Rico. I can confirm that Administrator Verma has shown a genuine willingness to help our island just as she did last year with the payment of fees to suppliers through administrative channels. Now, I am confident that we will achieve fair treatment in Medicare funds for the American citizens residing in Puerto Rico in the year 2019,” the resident commissioner added.

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