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  • Writer's pictureThe San Juan Daily Star

Lawmaker calls for reevaluation of Medicare Advantage Notice


Rep. José Enrique Meléndez Ortiz

By The Star Staff


At-large Rep. José Enrique “Quiquito” Meléndez Ortiz on Tuesday called on the board of the Centers for Medicare and Medicaid Services (CMS) to reevaluate the parameters of the Medicare Advantage Notice 2024, whose implementation, according to available information, would result in a marked reduction in the rates reimbursed to Advantage medical plans in Puerto Rico.


“Here is another area in which living under the colony affects us,” Meléndez said. “In Puerto Rico, which is the jurisdiction in the United States with the most citizens with Advantage health plans, out of 640,000, we receive only 40% to 43% reimbursement for the service of these plans in the states. Here the affected are our elderly people, and we cannot allow that.”


Members of CMS, the entity that groups insurers of Advantage medical plans, warned of a possible cut in the level of reimbursement for the federal fiscal year 2024, which begins Oct. 1. The cut, they said, could represent a decrease of up to $800 million compared to current levels.


A Medicare Advantage health plan is described as any private health plan provided by insurers that have current contracts with the Medicare program for those purposes.


“We believe that insurers will try to change these parameters in the Medicare Advantage Notice 2024,” Meléndez said. “We are asking the members of the CMS board to sit down, take into consideration the economic reality of those who are beneficiaries of these plans, mostly seniors, and avoid this action that would put the health system at risk in a critical area.”


“These plans are used by citizens to supplement their coverage, without them many could not pay for their medicines, because in Puerto Rico we do not receive subsidies in Part D (Medicare), among others,” the New Progressive Party lawmaker added. “These plans supplement basic Medicare coverage. We are not talking about anything other than the health of the people and that is why today we make an urgent call for this issue to be mobilized in favor of the U.S. citizens of Puerto Rico.”

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