Medicare Advantage (MA) programs were the talk of the town in Washington when first proposed in the late 1990s - positively so--but they do not always find a warm welcome on Capitol Hill of late. Rep. Pete Stark (D-California), the chairman of the House Ways and Means Committee's health subcommittee has gone on record as saying that he would like to cut funding for Medicare managed care plans and the current bill for the Children's Health Insurance Program (CHIP), coming out of the Senate Finance Committee funds a dramatic expansion of CHIP, partly by cutting MA funding. Making matters worse for MA plans is an announcement made by CMS that it has cancelled the contract of a south Florida provider for problems with plan service. On July 26, the Centers for Medicare and Medicaid Services reported that it had terminated its contract with America's Health Choice (AHC; Vero Beach, Florida) because 'AHC failed to make services available to the extent that it posed an imminent and serious threat to the health of AHC enrollees.' According to CMS, the provider had an MA enrollment of roughly 12,000. The CMS statement said that the enrollees will be folded into a preferred provider service offered by United Healthcare (Minnetonka, Minnesota), but beneficiaries who are enrolled in AHC's Part D prescription drug benefit are not affected as that contract is still in force. Until Sept. 27, former AHC enrollees who receive services from outside Secure Horizon's network will pay only the in-network co-pay, and any beneficiaries who are in treatment for serious acute illnesses will get those treatments for the in-network co-pays for up to 90 days. Until the end of the year, anyone receiving chemotherapy or radiation therapy will also have to pay only the in-network co-pay. AHC and American's Health Insurance Plans (AHIP; Washington), an insurance industry trade group, did not respond to calls for comment.
