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NEW MANAGED CARE PLAN OFFERED TO MEDICARE BENEFICIARIES ON STATEN ISLAND IN NEW YORK CITY
NEW MANAGED CARE PLAN OFFERED TO MEDICARE BENEFICIARIES ON STATEN ISLAND IN NEW YORK CITY
The Centers for Medicare & Medicaid Services (CMS) has approved a request by Touchstone Health Partnership Inc. of New York City to offer managed care coverage to Medicare beneficiaries on Staten Island, N.Y.
Touchstone Health Partnership will be a federally waivered, provider-sponsored organization (PSO) with a Medicare contract, as of Jan. 1, when the plan will begin serving beneficiaries.
With a federal waiver, the PSO is controlled for up to three years only by federal law and regulations, rather than by federal and state rules. The managed care entity also has shown that it will deliver a substantial portion of the Medicare services to its enrollees through the providers responsible for operating the PSO.
Medicare beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 63,400 beneficiaries live on Staten Island, a borough of New York City also known as Richmond County.
"We are pleased Touchstone Health Partnership will serve Medicare beneficiaries on Staten Island,” HHS Secretary Tommy G. Thompson said. "Under the Medicare reform law signed by President Bush, Medicare will provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The law is achieving the President's goals of strengthening and modernizing Medicare.”
The company will offer three plans under the Medicare Advantage program. The plans will give additional health care options to Medicare beneficiaries on Staten Island. These beneficiaries currently are served by Aetna Health Inc., Elderplan Inc., Empire HealthChoice HMO Inc., HIP of Greater New York, Health Net of New York, Oxford Health Plans, United Healthcare Insurance Co. of New York, and United Healthcare of New York.
Touchstone Health Partnership has contracted with its own Independent Physician Association’s member physicians practicing on Staten Island to provide primary care services for Medicare enrollees.
"We want to make sure all Medicare beneficiaries, whether in a Medicare Advantage plan or fee-for-service, are receiving the highest quality health care," said CMS Administrator Mark McClellan, M.D., Ph.D. "We are doing more to guarantee that beneficiaries understand the Medicare coverage options available to them. We also are reminding beneficiaries of the need to work closely with the doctors and other health care providers that give them medical care."
Since Dec. 8, when President Bush signed the Medicare Modernization Act into law, CMS has approved 15 new contracts with Medicare health plans and 42 service area expansions. There are currently 40 applications pending for new contracts and 17 service area expansions pending.
Medicare Advantage HMOs and fee-for-service plans are available where private companies choose to offer them. Currently, about 4.6 million Medicare beneficiaries -- out of a total of about 40 million aged and disabled Americans -- have enrolled in Medicare HMOs. Original fee-for-service Medicare, currently chosen by more than 35 million beneficiaries, is available to all beneficiaries.
Medicare has a far-reaching consumer information program that includes a national toll-free phone number -- 1-800-MEDICARE (1-800-633-4227) or TTY/TDD, at 877-486-2048 -- an Internet site -- www.medicare.gov -- and a coalition of more than 200 national and local organizations to provide seniors more information.