ROCKEFELLER EXPRESSES ONGOING CONCERNS ABOUT EFFORTS TO COORDINATE CARE FOR PEOPLE WHO QUALIFY FOR BOTH MEDICARE AND MEDICAID
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ROCKEFELLER EXPRESSES ONGOING CONCERNS ABOUT EFFORTS TO COORDINATE CARE FOR PEOPLE WHO QUALIFY FOR BOTH MEDICARE AND MEDICAID
"I have long been concerned about the health care needs of the 9.4 million Americans - and more than 80,000 West Virginians - who are simultaneously eligible for
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On
Rockefeller and five other members requested a
Below is Senator Rockefeller's statement as prepared for delivery:
Statement of Senator
Improving Care for Dually-Eligible Beneficiaries: A Progress Update
Thank you, Mr. Chairman, for holding this very important hearing today. And, let me extend a warm welcome to all of our witnesses. I look forward to hearing your testimony.
As I reflect on the title of this hearing - "Improving Care for Dually-Eligible Beneficiaries: A Progress Update" - the first question that comes to mind is progress for whom?
My serious concerns about the direction of the Federal Coordinated Health Care Office generally and the Financial Alignment Initiative specifically are well-documented in a July letter that I sent to Secretary Sebelius. Mr. Chairman, I'd like to ask that a copy of that letter be submitted for the record.
Unfortunately, despite CMS's guidance and public comments to the contrary, most of the concerns described in my letter have not been addressed. As MedPAC so eloquently stated in its July letter to CMS, "Even if the Commission agrees with CMS's stated guidelines, there is no assurance that the final structure of a demonstration within any given state will be fully consistent with CMS's guidelines." It is clear both from ongoing press reports and from the very agreements that CMS has reached with some of the states present here today that the rights and choices of
So, again, I ask the question progress for whom" Surely, we cannot mean progress for dual eligibles.
The Financial Alignment Initiative, as currently structured, runs counter to both the letter and the spirit of the statute regarding the Federal Coordinated Health Care Office. And, today, I again call on HHS and CMS to take immediate steps to halt this initiative as currently structured and to take the time necessary to develop a well-designed and thoroughly evaluated care coordination model for dual eligibles that meets the standards outlined in the law.
As the saying goes, "The best laid plans of mice and men often go awry." That seems to be an appropriate way to describe the Financial Alignment Initiative.
I have long been concerned about the health care needs of the 9.4 million Americans - and more than 80,000 West Virginians - who are simultaneously eligible for
As I have said many times before, we should not continue to treat low-income individuals eligible for
The complex health care needs of dual eligibles are often poorly managed, as they are forced to navigate a complex health care system with different eligibility rules, coverage standards, and benefits between the
In 1965, when we created
Perpetuating an arbitrary distinction among
The absurdity of such a division between populations eligible for
In fact, a significant portion of
A major reason that states currently have a long-run problem in their fiscal outlook is that they have absorbed responsibility for
Fortunately, we took a crucial step toward righting this wrong with passage of the 2003
Building on this provision for duals in the
* Improved care coordination.
* States cannot sustain the fiscal burden related to dual eligibles.
* The federal government is responsible for retirement programs.
*
*
Mr. Chairman, I ask that a copy of this paper be submitted for the record.
The Federal Coordinated Health Care Office, as initially envisioned in the Medicare Prescription Drug Coverage Improvement Act of 2009 and as enacted in the final health reform law, was created to test new and innovative models of care coordination for dual eligibles. It was not created to recycle old ideas already proven to be ineffective for this population, thereby risking the health of millions of
Managed care plans have not demonstrated success with even small numbers of dually eligible beneficiaries. Dual eligibles require a varying range and intensity of services--including an often vital need for services such as home health or personal care aides--that most
We had an opportunity through the Coordinated Care Office to test alternative models of care for duals in the
In creating the Coordinated Care Office,
Regrettably, we do not have to wait for implementation of the Financial Alignment demonstrations to see the negative effects that under-evaluated
Dually eligible beneficiaries in
Exponentially greater harm will come to dual eligibles if CMS continues to rush and get this wrong instead of taking the necessary time to think this through and develop a proven model to get this right. True progress for dual eligibles requires an immediate reversal of the Financial Alignment Initiative.
I thank the Chair.
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