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OIG: Medicare Advantage Prepayments Cost CMS Millions

Cheryl Clark, for HealthLeaders Media, January 24, 2011

The OIG report says it disagrees with CMS' contention that Medicare Advantage plans would simply raise rates to compensate for loss of investment income for the following reasons:

• Medicare Advantage payments are being decreased under the Health Care and Education Reconciliation Act of 2010. "This modification, coupled with the provision to restrict the total amount of administrative costs reimbursed by CMS to Medicare Advantage organizations...may discourage Medicare Advantage organizations from increasing future bid proposals to recoup investment income that they would lose."

• Market competition would create a disincentive for these plans to raise their bids.

• The Medicare trust funds, through long-term investments, yield higher returns than what Medicare Advantage organizations earn with short-term investments. "Thus, any decrease in the estimated cost savings caused by increases in Medicare Advantage organizations' bid proposals would be reduced because of the difference between the higher interest earned by the Medicare trust fund and the lower interest earned by the Medicare Advantage organizations."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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1 comments on "OIG: Medicare Advantage Prepayments Cost CMS Millions"


Don Grunt (1/29/2011 at 11:14 PM)
My question for the OIG is how come plans are waiting 46 days to pay for medical services when they are supposed to pay claims within 30 days? The biggest impact of this change would be to lengthen the time that it takes plans to pay claims to providers. That would make Medicare Advantage less popular when you consider that CMS will probably very slow with their payments to MA plans.