Special needs plans seek to avoid moratorium by providing more data to congress

Officials from special needs plan providers said Thursday at a Capitol Hill briefing that they will provide Congress with more data on the services the plans provide to beneficiaries with severe chronic medical conditions, CQ HealthBeat reports.

SNPs are offered through Medicare Advantage and serve so-called "dual eligibles," beneficiaries who qualify for both Medicaid and Medicare; beneficiaries with severe or disabling chronic conditions; and beneficiaries in long-term care facilities.

The plans were added under the 2003 Medicare law and since then have accounted for "much of the surge in overall [MA] enrollment," according to CQ HealthBeat.

However, the "plans haven't convinced some policy analysts that they are developing real expertise in managing care for Medicare's neediest enrollees in spite of the higher payment rates they receive," CQ HealthBeat reports.

Under Medicare legislation (S 2499) signed by President Bush in December 2007, SNPs cannot expand their service areas and no new plans can be introduced through Dec. 31, 2009.

Supporters of SNPs are seeking to get the moratorium lifted through Medicare legislation currently being debated in Congress (Carey, CQ HealthBeat, 4/24).