Epstein Becker Green Featured in HealthPlanMarkets Alert and AHIP Newsletter

Interpro Publications Inc., AHIP

Epstein Becker Green was recently featured in an America’s Health Insurance Plans (AHIP) email newsletter, titled “The MA Funding Formula Is Incorrect,” and a HealthPlanMarkets Alert, titled “AHIP Email: Wrong MA Formula Needs Fixing,” for its analysis of calculating Medicare Advantage (“MA”) payment rates.

Following is an excerpt from the HealthPlanMarkets Alert, “Wrong MA Formula Needs Fixing”:

The AHIP email cites an important new Epstein Becker & Green analysis backing the position by MedPAC that “certain counties are likely to have MA benchmarks based on FFS spending [that are] inaccurately measured” due to assumptions about congressional intent. The mistake: “inclusion in the AAPCC of costs attributable to beneficiaries enrolled only in Part A.” EBG, the leading U.S. health law firm, finds “Under a reading of the plain language of the statutory text cited above, Medicare Part A only beneficiary cost data should be excluded when calculating Medicare Advantage payment rates based on AAPCC.”