ALBANY, N.Y. – July 11, 2024 – CDPHP is calling on Congress to enact recently introduced bipartisan legislation to protect the benefits and access to care for hundreds of thousands of seniors enrolled in Medicare Advantage plans in Upstate New York.
CDPHP is urging quick action in support of legislation sponsored by Congresswoman Claudia Tenney (NY-24) and co-sponsored by Representatives Paul Tonko (NY-20), Elise Stefanik (NY-21), Joseph Morelle (NY-25), Marc Molinaro (NY-19), Brandon Williams (NY-22), Nick Langworthy (NY-23), and Mike Lawler (NY-17).
The Centers for Medicare and Medicaid Services (CMS) recently approved significant payment increases for hospitals throughout Upstate NY. The news was celebrated across NYS as cash-strapped hospitals received sizable increases to inpatient reimbursement rates ranging between 20 – 43 percent.
This change, however, resulted in significant financial hardships for not-for-profit health plans in Upstate New York, which are now being forced to slash benefits and increase premiums for local seniors who have come to rely on the high-quality, affordable coverage they receive from CDPHP.
“As a physician founded and guided health plan, CDPHP understands the critical role our hospital partners play in keeping our community healthy,” said CDPHP president and CEO, Brian O’Grady.
“While we support the additional funding being provided to our local hospitals, these funding changes have left the future of our great health plan – and the 65,000 seniors who entrust us with their care – in jeopardy. We applaud our Upstate delegation for taking action on this important issue, and we respectfully request Congress pass this important legislation.” added O’Grady.
Health insurers use the federal government reimbursement rates to determine payments for hospitals who take care of Medicare Advantage members. The health plans are now reimbursing hospitals more for Medicare Advantage members without a corresponding increase in government funding, thus resulting in a massive unfunded mandate.
The funding gap will undoubtedly impact the affordability of Medicare Advantage plans in Upstate New York, resulting in out-of-pocket increases and reductions in benefits for seniors. The legislation would adjust the rates the federal government reimburses health plans, allowing seniors to maintain their robust benefits and access to quality care.
Please read this news release to learn more about this bipartisan effort.
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About CDPHP®
Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 36 counties throughout New York. CDPHP is also on Facebook, X, LinkedIn, and Instagram.