Statement Of ACAP Ceo Margaret A. Murray On The ‘Fiscal Cliff’ Agreement

“While ACAP, like many in Washington, is still going over the fine print of the agreement reached last night by Congress, we are glad to see that the agreement includes an extension of the authorization of Medicare Advantage Special Needs Plans through 2014. Such plans serve the most vulnerable and medically needy Medicare beneficiaries—in particular, those who qualify for both Medicaid and Medicaid, or ‘dual eligibles.’ Among ACAP Safety Net Health Plans, 25 members offer Special Needs Plans, covering a total of more than 100,000 dually eligible beneficiaries.

“But because Medicare and Medicaid are separately administered programs, these beneficiaries are often poorly served. Incentives to shift costs between the two programs lead to unnecessarily high spending across both programs. Special Needs Plans provide an integrated, coordinated care setting for dual eligibles. These plans were required to send CMS notice of intent to operate in 2014 prior to December 31, but the Special Needs Plan program was only authorized through 2013.
“A longer-term extension would have been preferable, but this agreement preserves current options and gives Special Needs Plans and the beneficiaries they serve a measure of certainty and stability for 2014. We expect a serious discussion on a permanent setting for integrated care for dual eligibles to be on the agenda of the next Congress. ACAP and its members believe that better-coordinated care for duals can lead to better health outcomes while at the same time containing cost growth. We have a great deal to offer to the conversation about improving care for dual eligibles, and look forward to holding such discussions in the new year.”

About ACAP
ACAP represents 58 nonprofit Safety Net Health Plans in 24 states, which collectively serve nearly ten million people enrolled in Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), and other public health programs. For more information, visit www.communityplans.net .