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  • Writer's picturePress Release

Amid Continued Disparities, MMAPA Urges CMS for Improvements to the 2024 Medicare IPPS Proposed Rule

MMAPA expresses support for the Puerto Rico Hospital Association’s recommendations to ensure the 2024 Medicare IPPS Proposed Rule delegates more equitable payments to hospitals on the island.

Recently, MMAPA, the Medicaid and Medicare Advantage Products Association of Puerto Rico, and the Puerto Rico Hospital Association submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) advocating for policy fixes around the proposed rule for the 2024 Medicare Inpatient Prospective Payment System. In the letter, the organizations called on CMS to ensure the proposed rule is adjusted to ensure that hospitals in Puerto Rico receive equitable payments to cover the costs of operating and delivering quality care to the oldest, poorest, and most vulnerable populations on the island. MMAPA also expressed support for CMS’s decision to maintain the Low Wage Index Hospital Policy, which raises the wage index for hospitals below the 25th percentile and improves access to equitable care for Medicare beneficiaries on the island. Roberto Pando Cintrón, President of MMAPA, issued the following statement regarding CMS’s proposed rule and the organizations’ comment letter: “Puerto Rico’s healthcare system has been underfunded for decades, and this disparity has put the most vulnerable populations on the island at risk. MMAPA continues to seek fixes for historic anomalies that offer disproportionately lower payments to Medicare Programs in Puerto Rico compared to any other state or territory. The Puerto Rico Hospital Association’s proposed technical adjustments to CMS’s supplemental payment system would ensure that hospitals on the islands receive more equitable payments to cover operating costs, patient care, essential healthcare services and more,” said Pando Cintrón. “The anomalous results of Part A payment formulas for Puerto Rico risk increasing the disparity in MA benchmarks. With a history of statutory differences and only 6% of all Medicare Part A and B beneficiaries in traditional Medicare, the formula for MA rates keeps Puerto Rico at 39% below the U.S. average, 37% below the lowest state, Hawaii, and 21% below the MA rates for the U.S. Virgin Islands.” “We ask CMS to continue using its authority to address anomalies that cause Part A and MA payments to be disproportionately lower than the rest of the country. This is an unintended consequence that results from applying the standard formula that does not adjust to the history of statutory differences and data deficiencies for the Medicare program in Puerto Rico, and it ultimately impacts over 700,000 beneficiaries on the island.” “We are appreciative of the Biden Administration’s efforts to maintain the Low Wage Index Hospital Policy to combat Medicare funding disparities in Puerto Rico, as ending the policy would reduce Medicare IPPS payments to Puerto Rico hospitals by as much as 12% over time, harming not only Original Medicare Beneficiaries but also 648,000 beneficiaries enrolled in Medicare Advantage (MA) plans on the island.” “The American citizens of Puerto Rico deserve equal access to affordable healthcare, and supporting these efforts will help guarantee that they have equitable access to the care they need.” To learn more, read the full comment letter here.

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