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washingtonscene MOAA agrees with the panel’s opposi-
Legislative UPDATE
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tion to the TRICARE proposals. TRICARE’s design is to support military readiness, including military-family readiness. The civilian health care plans proposed by the MCRMC serve a very different purpose and fail to factor in military readiness. “The unintended consequences could
be severe,” says Capt. Kathy Beasley, USN (Ret), a MOAA deputy director of Gov- ernment Relations. Earlier this year, four out of five MOAA members surveyed said they preferred TRICARE to a health insurance system similar to that of federal civilians. While the services seem poised to reject the TRICARE proposals in the MCRMC report, the military community seems di- vided over the commission’s pay reforms.
Permanent Doc
Fix Passes Legislation replaces flawed payment formula.
P
resident Barack Obama signed legislation April 16 preventing a 21-percent cut to providers who
treat Medicare patients. The legislation came after Congress returned from a two- week recess and set aside partisan differ- ences to provide stability to doctors who accept Medicare. By a vote of 92-8, the Senate overwhelm-
ingly approved legislation that permanently replaces the formula used to pay provid- ers treating Medicare patients. The House passed its version of the bill by a vote of 392-27 before adjourning for recess. Because TRICARE reimbursement
rates are tied to Medicare’s, this legislation affects TRICARE beneficiaries of all ages. Providers technically had payments cut by 21 percent April 1, while Congress was in
40 MILITARY OFFICER JUNE 2015
recess. Since then, the Center for Medicare and Medicaid Services has relied on ad- ministrative lag times from when Medicare receives claims to when it actually makes payments to avoid imposing the pay cuts. The legislation is part of an effort to
move away from a fee-for-service pay- ment model and shift toward a value- based payment system. The fix changes the sustainable
growth rate formula, a flawed legislative mechanism used to pay medical provid- ers who see Medicare and TRICARE patients. The formula was designed to incentivize providers to control medical spending by rewarding physicians when the rate of spending on physician services fell below the growth in gross domestic product. However, medical inflation con- sistently outpaced overall inflation, lead- ing to scheduled cuts. Cuts to reimbursement rates led to
many providers dropping TRICARE and Medicare patients. Fearing a dramatic disruption in access to care for millions of Americans, Congress prevented the cuts 17 times between 2003 and 2015. However, each time Congress delayed action, the amount of scheduled cuts and cost of a permanent fix grew. Throughout it all, MOAA members sent nearly 1 million messages to their elected officials urging a permanent resolution. A permanent deal helps sustain Medi-
care and TRICARE For Life benefits. “MOAA members can be proud that they did their part to help millions of Americans keep their health providers,” says Capt. Kathy Beasley, USN (Ret), a MOAA deputy director of Government Relations. “With over 1 million messages sent to Congress, one thing is certain, MOAA members rep- resent a powerful voting bloc.” MOAA thanks Congress for coming up with a bipartisan solution to prevent cuts to reimbursement rates.