Central Louisiana News

WASHINGTON - U.S. Senators Bill Cassidy, Catherine Cortez Masto, Elizabeth Warren, and Marsha Blackburn have introduced the Encounter Data Enhancement Act, a bipartisan legislation aimed at improving transparency in Medicare Advantage (MA) plans. The bill seeks to ensure that these plans effectively meet the healthcare needs of America's seniors by requiring them to report important information regarding patient services and out-of-pocket costs.

Dr. Cassidy emphasized the importance of transparency, stating, "Just as price transparency is good for patients, data transparency is good for the federal taxpayer." He added that transparency enables taxpayers to understand how Medicare program funds are being utilized and whether they can be better allocated.

Senator Cortez Masto highlighted the need for transparency in Medicare Advantage plans, stating, "American taxpayers are paying hundreds of billions of dollars for seniors to use Medicare Advantage plans, but the federal government still doesn't know how much these plans are paying for patient services and how much patients are being forced to pay out-of-pocket." She believes that the legislation will provide transparency, enabling appropriate oversight and ensuring that seniors receive optimal healthcare coverage.

Senator Warren expressed concern over the fraudulent practices of Medicare Advantage plans, stating, "For years, Medicare Advantage plans have been using a long list of tricks to overcharge the government for coverage, while delaying and denying care for seniors." She believes that strengthening data transparency through the bipartisan bill will empower lawmakers and regulators to address fraud and abuse, ensuring that taxpayer dollars are used to deliver high-quality coverage for Medicare beneficiaries.

Senator Blackburn emphasized the importance of transparency as the preference for Medicare Advantage grows among seniors. She stated, "As the preference for Medicare Advantage grows among seniors because it provides more robust benefits beyond traditional Medicare, it becomes essential to encourage transparency in participating plans." The legislation aims to foster greater clarity in billing practices, promote competition, and create a robust Medicare Advantage market for future generations.

Currently, $454 billion, accounting for 54% of total federal Medicare spending, is allocated to Medicare Advantage plans. These private insurance companies contract with the government to provide Medicare coverage for over 30 million Americans. While Medicare Advantage plans are already required to report encounter data, these records may be incomplete or lack essential information for combatting fraud.

The Encounter Data Enhancement Act will provide researchers and policymakers with a clearer understanding of plan payments to providers and the out-of-pocket costs incurred by patients. The legislation aims to facilitate oversight of federal funds allocated to Medicare Advantage plans, assess the quality of care provided, and strengthen healthcare access for seniors.

The introduction of the Encounter Data Enhancement Act marks a significant step towards increasing transparency and ensuring that Medicare Advantage plans effectively serve the healthcare needs of America's seniors.

To find out more, go to this link: https://www.cassidy.senate.gov/news/press-releases/cassidy-cortez-masto-warren-blackburn-introduce-legislation-to-increase-transparency-over-medicare-advantage-plans/