Newswise — The American Academy of Dermatology Association (AADA) announced its support for the Medicare Advantage Bill of Rights Act, introduced today by Sen. Sherrod Brown (D-Oh.) and Rep. Rosa DeLauro (D-Conn.). If passed, the legislation would ensure that patients will have adequate physician networks in their Medicare Advantage plans.
“In recent years, inadequate and inaccurate information about physicians available in Medicare Advantage networks has led to barriers for patient access to care, and increased costs for patients,” said Mark G. Lebwohl, MD, FAAD, president of the AADA. “This bill holds insurers accountable by increasing transparency, and it ensures that Medicare Advantage patients’ will have access to care from a qualified physician. With nearly 17 million seniors enrolled in private Medicare Advantage plans, we need to put their care and well-being first.”
Reports and research over the past several years have shown that MA plan network directories are inaccurate, and often include physicians who are no longer in-network, not accepting new patients, and in some cases, are deceased.
In addition, after purchasing an MA plan, patients are not receiving the benefits they had hoped for as plans have been dropping physicians from networks mid-year –at a point when most plan enrollees are not permitted to change plans. MA enrollees often receive little advance warning, and some lose access to physicians they have seen for a long time, despite joining the plan specifically because their doctor was part of the network.
The Medicare Advantage Bill of Rights Act would:• Improve network adequacy standards for MA plans and requiring CMS to review MA networks on a more regular basis;• Prohibit plans from dropping doctors without cause during the middle of a coverage year; and• Enhance transparency by requiring MA plans to disclose the reasons for dropping providers.
A recent Government Accountability Office report found that the Centers for Medicare and Medicaid Services (CMS) must take action on network adequacy standards and requirements to ensure seniors could access an appropriate number of doctors.
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