Washington, D.C. - Congresswoman Elise Stefanik joined Congresswoman Claudia Tenney (R-NY) in co-leading legislation to address the significant under projection of Medicare Advantage (MA) local growth due to wage index reclassification.
The Centers for Medicare and Medicaid Services (CMS) uses the Medicare Wage Index to help determine how much the federal government should reimburse hospitals that provide care for patients with original Medicare. The wage index adjusts a hospital’s payments based on labor costs for a specific geographic area. It is also common for health plans to use the same payment rates for hospitals caring for its MA members.
In 2023, CMS finalized its FY24 Inpatient Prospective Payment System (IPPS) Rule, updating the wage index and reclassified many hospitals as “rural.” The federal government did not give higher reimbursements to MA insurers. As a result, regional plans who solely service Upstate New York are being negatively impacted and without a fix from CMS, the wage index increase could significantly raise out-of-pocket costs and premiums for the 119,183 MA beneficiaries living in NY-21.
“Ensuring our seniors have access to the most affordable health plans and are able to maintain their popular Medicare Advantage benefits is one of my top priorities which is why I am proud to co-lead this legislation to address the wage index reclassification,” said Congresswoman Elise Stefanik.
“Our community's seniors deserve continued access to affordable, high-quality healthcare,” said Congresswoman Claudia Tenney. “By adjusting the benchmark rates to reflect the increased costs faced by our regional plans, we can protect our seniors from losing essential coverage and experiencing higher premiums. This bill will ensure that Medicare Advantage plans continue to provide the robust benefits that so many members of our community rely on.”
Read the full text of the bill here.
