Medicare/Medicaid

Potential reform options addressing Medicare’s financial sustainability, and information on the Medicaid and CHIP programs.

Medicare Steering Committee annual issue brief offering an actuarial perspective on Medicare's financial condition. (April 30, 2007)
Part D Lessons Learned Work Group comment letter on what has worked well and what has not in Medicare Part D. The letter also offers recommendations to improve the overall operation and administration of the Part D program, specifically including the bidding process, management of eligibility, and coordination with Medicaid and with the Social Security Administration. (March 21, 2007)
Health Practice Council comments that urge CMS to reconsider the one-role-per-user rule for actuaries for Part D attestations and to investigate alternatives that would not prevent actuaries from fulfilling their actuarial obligations. (December 19, 2006)
Medicare Supplement Work Group comments to NAIC's Medigap Modernization Subgroup of the Senior Issues Task Force identifying potential transitional issues that will need to be addressed as part of Medicare Supplement modernization that the Subgroup has recently taken up. (August 17, 2006)
Practice note created by the Actuarial Equivalence Retiree Practice Note Work Group providing advisory guidance to actuaries attesting to the actuarial equivalence of a plan sponsor's retiree health plans for payments to sponsors of retiree prescription drug plans. (March 8, 2006)
Medicare Part D RBC subgroup report to the NAIC on proposed RBC risk factors relating to the insurance of Medicare Part D coverage commencing January 1, 2006. This report was written in response to a charge from the NAIC. (December 3, 2005)
Health Care Quality Work Group issue brief exploring definitions and measures of health care quality and examining the pay for performance approach to rewarding improvements in quality, particularly in the Medicare program. (October 1, 2005)
Report to NAIC on Proposed Medicare Part D RBC changes
Memo to the NAIC from the Medicare Part D Subgroup with proposed health RBC instruction and health RBC formula changes, proposed life RBC instruction and life RBC formula changes, and explanatory slides. (September 10, 2005)
Medicare Part D Subgroup explanatory slides from a memo to the NAIC regarding 2006 RBC changes to Medicare Part D Prescription Drug Coverage. (September 10, 2005)
Health RBC Subgroup status report to the NAIC Task Force. The subgroup was created in response to and NAIC charge for recommendations of changes to the 2006 RBC Formulas and Instructions, in order to address the risks of Medicare Part D Prescription Drug coverage. (June 11, 2005)
Cori E. Uccello and Ron Gebhardtsbauer Capitol Hill briefing regarding the 2005 trustees report, for Medicare and Social Security, demographic changes affecting both programs, and solvency issues. (April 1, 2005)
Letter offers the Academy as a resource on health care issues and shares some recent publications on key issues including Medicare and the uninsured. (March 4, 2005)
Academy comment letter recommending to Congress that individuals serving in the positions of SSA and CMS chief actuary be members in good standing of the American Academy of Actuaries. (March 3, 2005)
Senior Health Fellow issue brief outlining areas in which action, beyond the addition of the Medicare Part D program, could be taken to reform the Medicare program, including addressing long- term financing problems, balancing access to care while avoiding unnecessary utilization, private sector competition strategies, and addressing the insurance needs of individuals age 55 to 64. (February 1, 2005)
Actuarial Equivalence Work Group letter to CMS regarding actuarial equivalence issues related to prescription drug plans (PDPs), Medicare Advantage (MA) plans, Medicare supplement plans, and retiree health benefits. (October 4, 2004)
Medicare Steering Committee letter to CMS discusses issues related to the calculation of monthly savings — a step in determining beneficiary rebate amounts for MA plans — and payment adjustments based on the variation in costs among different areas including input prices, utilization, and practice patterns. (October 4, 2004)
Medicare Steering Committee letter discusses issues related to eligibility and enrollment, benefits and beneficiary protections, submission of bids and monthly beneficiary premiums, payments to prescription drug plan sponsors and Medicare Advantage (MA) organizations, etc. Comments on issues related to actuarial equivalence in a separate letter. (October 4, 2004)
Medicaid Work Group issue brief identifying several provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 that may have an impact on state Medicaid budgets. (June 30, 2004)
Joint Committee on Retiree Health comments to FASB opportunity to comment on the proposed FASB staff position (FSP) 106-b, Accounting and Disclosure Requirements Related to the Medicare Prescription Drug, Improvement and Modernization Act of 2003. (April 13, 2004)
Health Savings Account Subgroup comments on IRS Notice 2004-2, which provides guidance on Health Savings Accounts (HSAs) provisions in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. (March 30, 2004)