Knowing where Medicare Advantage dollars go is top priority, CMS administrator says

Knowing where Medicare Advantage dollars are being spent is a top priority for CMS, Administrator Chiquita Brooks-LaSure said at the Milken Future of Health Summit on Dec. 8. 

Medicare Advantage plans are facing allegations they have defrauded the government by making patients appear sicker than they are and receiving more payments. 

Ms. Brooks-LaSure said in her role as administrator, it is important to support options for Medicare Advantage and traditional Medicare. 

"There's certainly things we are concerned about in Medicare Advantage, primarily among those making sure that people are getting access to the care that they need," Ms. Brooks-LaSure said. 

"We just put out new proposed rules around making sure plans across the board, including Medicare Advantage, really looking at prior authorizations, we've been looking at concerns around marketing and monitoring, and certainly one thing we continue to want to focus on is making sure our dollars are being used well," she added. 

A top priority for the agency, Ms. Brooks-LaSure said, is determining how supplemental Medicare Advantage benefits are being used. 

"We know when we get Medicare Advantage bids, what people are saying they're going to spend their dollars on," she said. "What we want to see more of is, are Medicare beneficiaries using those benefits? What are they using? How are those dollars being spent?"

The question of whether or not plans are being overpaid by the government comes down to comparing Medicare Advantage and traditional Medicare, Ms. Brooks-LaSure said. 

"What does [Medicare Advantage] look like relative to fee-for-service? That's a process that we go through every year and will continue to look at," she said. 

See the full interview here. 

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