[Congressional Record Volume 153, Number 106 (Thursday, June 28, 2007)]
[Extensions of Remarks]
[Page E1450]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            THE MEDICARE ADVANTAGE TRUTH IN ADVERTISING ACT

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Thursday, June 28, 2007

  Mr. STARK. Madam Speaker, Medicare Advantage Plans--by name and by 
advertising--promote that they provide added value to the Medicare 
benefit.
  But under current law, MA plans are allowed to manipulate cost 
sharing for Medicare benefits. In some instances, enrollees save 
compared to Medicare. In many other instances, they spend more than 
they would in the traditional Medicare program. Few seniors or people 
with disabilities understand that--depending on their health--they 
could spend far more in a Medicare Advantage plan than they would under 
traditional Medicare.
  Beneficiaries are often charged more for home health, skilled nursing 
facilities, hospitalizations, durable medical equipment, Part B drugs 
(chemotherapy being the biggest service), and inpatient mental health 
services. These services are vital to millions of Medicare 
beneficiaries who face multiple chronic conditions and depend on 
affordable health care for their very lives.
  As Barbara Kennelly, President of the National Committee To Preserve 
Social Security and Medicare so aptly puts it, ``While MA plans are 
required to cover everything that Medicare covers, they do not have to 
cover every benefit in the same way.''
  The Medicare Rights Center emphasizes that, ``On a daily basis, our 
counselors assist older adults and people with disabilities enrolled in 
these plans who run into unexpectedly high out-of-pocket costs for 
their health care.''
  In my district in California, one of the major MA plans in our 
community charges $275 a day for the first 10 days in the hospital. 
This compares to a single charge of $992 in traditional Medicare for a 
hospital stay of up to 60 days. That means patients in this so-called 
Medicare Advantage plan who have to go to the hospital for 10 days are 
paying $2750 instead of $992--that is not an advantage!
  With regard to home health benefits, Medicare charges no copayment 
for these services as recipients tend to be the most frail, 
elderly women who are often widows and living on very low fixed 
incomes. Yet many MA plans charge a 20 percent copayment for home 
health. They also impose tough utilization review standards to further 
restrict access to this needed benefit for our most at-risk 
beneficiaries.

  Attached is a chart which further highlights how beneficiary cost 
sharing for various services in a variety of MA plans surpasses 
Medicare's cost-sharing for those same services. It is just an 
illustrative sampling.
  The Medicare Advantage Truth in Advertising Act would fix this 
problem. It would require MA plans to cover all of Medicare's benefits 
with no greater cost-sharing than is charged in the traditional fee-
for-service Medicare program. It would preserve the ability of MA plans 
to use flat copayments and per diem rates in lieu of deductibles and 
co-insurance charged in traditional Medicare, but it would prohibit 
their costs from exceeding the overall fee-for-service cost. In other 
words, it holds private plans to their propaganda that they're an 
advantage.
  This is a simple bill. It holds Medicare Advantage plans to their 
word and assures Medicare beneficiaries that they won't face higher out 
of pocket costs if they choose to join one of the private plan options 
so heavily promoted in Medicare today.
  With thousands of different MA plans out there and numerous 
complaints being filed about inappropriate and illegal sales 
techniques, the least we can do is assure Medicare beneficiaries that 
they'll still be eligible for Medicare-covered services at no more than 
Medicare prices.
  I developed this bill in direct response to testimony presented by 
Medicare beneficiary advocates before our Ways and Means Health 
Subcommittee this year. I am pleased that numerous groups support this 
bill, including the National Committee to Preserve Social Security and 
Medicare, the Medicare Rights Center, Consumers Union, the Alliance for 
Retired Americans, the Center for Medicare Advocacy, Families USA, the 
National Senior Citizens Law Center and California Health Advocates.
  I urge you to join me in support of this common sense improvement to 
the Medicare Advantage program.

                          ____________________