USA
Medicare Managed Care Plan Offered in Most of New York City
By CMS, U.S.
Mar 31, 2005, 20:56

The Centers for Medicare & Medicaid Services (CMS) has approved a request by New York-Presbyterian Community Health Plan to offer managed care coverage to Medicare beneficiaries throughout New York City except Staten Island.

New York-Presbyterian Community Health Plan, based in New York City and affiliated with New York-Presbyterian Hospital, will operate a health maintenance organization (HMO) that will begin serving beneficiaries on April 1 in the boroughs of Manhattan , the Bronx, Brooklyn and Queens. Medicare beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 980,000 beneficiaries live in these four boroughs.

"We are pleased the New York-Presbyterian Community Health Plan decided to offer this health plan to beneficiaries in four boroughs of New York ,� HHS Secretary Mike Leavitt 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, doing business as Secure Health Medicare Advantage Plan, will give another health care option to beneficiaries in the four boroughs, which also are the counties of New York (Manhattan ), Kings (Brooklyn), the Bronx and Queens . Eleven other Medicare Advantage plans currently operate in the four boroughs.

New York-Presbyterian Community Health Plan, founded in 1995, received its current name in 2002 as a result of the merger of New York Hospital and Columbia Presbyterian Medical Center .

"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, 2003, when President Bush signed the Medicare Modernization Act into law, CMS has approved 53 new contracts with Medicare health plans and 73 service area expansions. There are currently 212 applications pending for new contracts and 107 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.

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