Jenniffer González seeks action to retain physicians in Puerto Rico

by | Apr 4, 2017 | Congress | Comments

Puerto Rico Resident Commissioner Jenniffer González-Colón seeks to promote the retention of medical professionals in the US territory through measures that begin with justice in the fee schedules for the Medicare Advantage program providers, which today are incongruous with the islands’ reality and much lower compared with other states and territories.

“Over half a million patients in Puerto Rico are Medicare Advantage beneficiaries, but our physicians receive on the average a much lower payment tan they should since the formula for computing those fees fails to take into consideration that 73 to 75% of the Medicare eligible population have subscribed to Medicare Advantage plans, which is over double the number in any other state and, it’s worth pointing out, are the subscribers with the lowest income levels and higher rate of chronic illness in the system”, González-Colón pointed out.

The Resident Commissioner added that “this disparity in reimbursements is a factor in the flight of our health care professionals, who elsewhere in the nation could receive up to twice the compensation for the same service rendered here. It has been estimated that over the last six years we have lost 20% of our licensed physicians, five hundred of them just in the last year. Our island is becoming devoid of specialists, creating increasing waiting times for patients and putting their health at risk. Our call for equality in Medicare Advantage fees is one strategy to keep health care providers in Puerto Rico”.

This week Congresswoman Gonzalez-Colon led a joint effort to in which Republican congressmen Sean Duffy of Wisconsin, Carlos Curbelo, Mario Díaz-Balart and Ileana Ros-Lehtinen of Florida and Florida Senator Marco Rubio, added their voices to this call. In a written communication arranged by González-Colón to the Administrator of the Centers for Medicaid and Medicare Services (CMS), they urge for an administrative revision of the fee structure applied to the Medicaid Advantage providers in Puerto Rico.

The Resident Commissioner explained that since Florida receives the largest share of the current impact of the movement of Puerto Ricans to the mainland, she sought to have her congressional colleagues from this state join in this effort.

Puerto Rico’s assigned provider fees are equivalent to 26% less than those for the geographically nearest territory, the US Virgin Islands, and 38% less than the lowest-reimbursed state, Hawaii. Over 75% of the island’s Medicare-eligible population, nearly 580,000 of whom 280,000 are also Medicaid eligible, are subscribed to Medicare Advantage plans.

This is not the first action by the Resident Commissioner on behalf of better provider reimbursement rates under Medicare Advantage. Besides personally bringing it up with congressional colleagues and the Health and Human Services (HHS) Secretary in prior meetings, last January 27 she circulated a letter co-signed by 15 other Members of Congress to the acting heads at the time of HHS and CMS calling for action on the issue. The latest communication has been presented to the new head of CMS, Seema Verma.

The improvement on the reimbursement schedule for Medicare Advantage providers would be in accordance with the recommendation to that effect issued last December by the bicameral and bipartisan Puerto Rico Economic Development Task Group.

In González-Colón’s letter she also touched upon the need to have the agency review program aspects such as continued adjustments for beneficiaries with no claims and providing access to Medicare Part D in Puerto Rico.