Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

The “Medicare Advantage Quality Payment Relief Act” was introduced on April 8, 2019 by Reps. Ron Kind (D-WI), Mike Kelly (R-PA), Brett Guthrie (R-KY), and Mike Doyle (D-PA). AHIP has addressed a letter to the bill’s sponsors, expressing support for this bipartisan legislation.

This legislation would remove a payment cap (“benchmark cap”) that currently prohibits Medicare Advantage plans operating in certain parts of the country from receiving the full bonus payments they have earned under the program’s Star Ratings System.

The letter from AHIP explains: “For many Americans with a Medicare Advantage plan, this payment cap creates an unlevel playing field, which means that seniors participating in these plans could be missing out on important savings and services. This policy is inconsistent with the broader goals of rewarding high quality performance and continued improvement in the delivery of care to people eligible for Medicare.”

Click below to view the full letter

Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.