Governor of Puerto Rico urges the U.S. Department of Health and Human Services to provide funding for Medicare advantage program

Gov. Vázquez Garced sent a letter to Alex Azar II, secretary of the U.S. Department of Health and Human Services (HHS),  Seema Verma, administrator, Center for Medicare & Medicaid Services (CMS) and Demetrios Kouzoukas, principal deputy administrator & director of CMS urging them to identify ways to restore more equitable funding for Puerto Rico for  fiscal year 2021 for the Medicare Advantage (MA) program.

This program serves more than 585,000 seniors on the island. The letter outlined several priorities of the government to address some of the short-term healthcare challenges facing the elderly population on the island.

In the letter, the government proposes several changes to MA funding as detailed in the recently released Advance Notice for 2021 and urges CMS to use the period prior to the release of the Final Call Letter to identify ways to restore a more equitable 2021 funding for Puerto Rico’s  MA program. The letter reiterated that the island’s current payment rate stands at 42 percent below the U.S. national average, below Hawaii (the lowest state in the nation) and the U.S. Virgin Islands. Furthermore, Puerto Rico has more than 40 percent of citizens on the island living below the poverty line and the highest participation of MA beneficiaries in the nation, at approximately 75 percent. Additionally, 280,000 beneficiaries in Puerto Rico are dually eligible for Medicare and Medicaid. However, the MA program in Puerto Rico has the lowest payment rate by far in the entire program and beneficiaries do not receive the same Part D Low-Income subsidies as citizens in the rest of the United States. Using the period prior to the release of the Final Call Letter would present an opportunity to help improve Puerto Rico’s healthcare system.

“We urge Secretary Azar, Administrator Verma, and Deputy Administrator Kouzoukas to use this period prior to the release of the Final Call Letter to identify ways to make Puerto Rico’s Medicare Advantage Program more equitable. This would address in the short-term, several challenges of our healthcare system,” said attorney Jennifer M. Storipan. “I believe our most senior citizens must have access to much-needed quality healthcare. We must take action to ensure the welfare of our seniors.”