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Puerto Rico fiscal board urges Congress to consider PRIMA bill

By on November 14, 2018

SAN JUAN – The Financial Oversight and Management Board for Puerto Rico wrote to the U.S. congressional leadership Wednesday, requesting they address the disparity between the island and other stateside jurisdictions with regard to healthcare funding.

The board said that Medicare Advantage “reimburses just 57% of the average federal reimbursement rate in other states to pay for doctors and medical providers,” and last year’s hurricanes “contributed to the population exodus to the mainland, impaired the ongoing efforts to get the Island back on track, and delayed the goal of achieving sustainable economic growth.”

It stressed that the situation “affects the viability of doctors and service providers of Medicare beneficiaries to continue working in Puerto Rico, further exacerbating the exodus of physicians.”

The board believes that H.R. 6809, the “Puerto Rico Integrity in Medicare Advantage Act” (“PRIMA”), is “an important remedy to this problem.”

PRIMA was introduced by Resident Commissioner Jenniffer González-Colón and has received bi-partisan support. It seeks to establish a 0.70 Average Geographic Adjustment (AGA) floor for each county in the United States.

“This increase would have a significant impact on Puerto Rico’s private health sector. The bill establishes a three-year sunset of this increase, sufficient to counterbalance the long-term effects of the devastation caused by the hurricanes,” the board’s executive director, Natalie Jaresko, wrote.

“We believe that PRIMA would help stabilize and rebuild the health infrastructure and physician workforce in Puerto Rico. Under current law, MA plans must spend a minimum of 85% of payments received on provider payments or additional benefits. Beyond the current federal requirements, the bill requires MA plans to spend at least half of any incremental funding received on provider payments.

“Lastly, PRIMA is also consistent with the PROMESA-established Congressional Task Force on Economic Growth in Puerto Rico Report to the House and Senate of December 20, 2016, which specifically recommended that Congress consider legislative steps ‘to ensure that MA plans, including those in Puerto Rico, are being fairly and properly compensated for the services they provide to beneficiaries,'” Jaresko concluded.

The letter was addressed to Senate Majority Leader Mitchell McConnell Jr., Speaker Paul Ryan Jr., Senate Minority Leader Charles Schumer and House Minority Leader Nancy Pelosi.

Read the full text of the letter here: FOMB – Letter to Congress re HR 6809 – 20181114

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