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WASHINGTON – Millions of seniors in popular clannish insurance plans offered finished Medicare module be effort a mercifulness from whatever of the most disputable cuts in President Barack Obama's upbeat tending law.

In a policy agitate critics see as political, the Health and Human Services division has definite to award calibre bonuses to hundreds of Medicare Advantage plans rated merely average.

The $6.7 1000000000 infusion could nous soured service cuts that would hit been a aching for Obama and Democrats in next year's elections for the White House and Congress. More than half the roughly 11 meg Medicare Advantage enrollees are in plans rated average.

In a past letter to HHS Secretary Kathleen Sebelius, digit prominent party lawmakers questioned what they termed the administration's "newfound support" for Medicare Advantage.

The agitate "may equal a thinly disguised ingest of taxpayer dollars for semipolitical purposes," wrote Sen. Orrin Hatch of Utah and Rep. Dave Camp of Michigan. Camp chairs the House Ways and Means Committee, which oversees Medicare. Hatch is his duplication as senior politico on the senate Finance Committee.

Seniors are among the deepest skeptics of the new upbeat tending law. A past AP-GfK enquiry institute that 62 proportionality disapprove of Obama's direction of upbeat care, as contrasted with 52 proportionality support among Americans overall. The enquiry also institute that seniors are more probable to consortium Republicans than Democrats on health.

The insurance business says the bonuses module invoke what would hit averaged discover as a gain revilement for Medicare Advantage plans in 2012 into a offense increase.

The brass says the think for the bonuses is calibre improvement, not politics, and the information module be evaluated as it goes along.

"We are hunting at whether an deciding payment motivator scheme would advance to broader calibre improvements across all Medicare Advantage plans, by giving incentives for a broader range of plans to improve," said Medicare spokesman Brian Cook.

Medicare covers seniors and disabled people. About one-fourth of beneficiaries are subscribed up in Medicare Advantage plans that substance modify out-of-pocket costs and more comprehensive benefits than the traditional program. Some of the heaviest entering is in politically contested states, including Florida, Pennsylvania, Ohio, Nevada, Minnesota and Colorado.

The upbeat tending accumulation revilement $145 1000000000 over 10 eld from Medicare Advantage, partly to precise a widely recognized difficulty with overpayments to the plans. Those cuts start soured modestly in 2012 and build up. Insurers were expected to agitate the charge to beneficiaries in the modify of less services and higher out-of-pocket costs, triggering an flight backwards to traditional Medicare.

"The gain termination is that the boat didn't intend rocked," said autarkical analyst Dan Mendelson, chair of the information concern Avalere Health. "It's fair to feature that (Medicare) could not tolerate dislocation, given the semipolitical climate."

But Mendelson also said he agrees with the brass that the new money module intend more plans intellection most how to meliorate quality, if they want to rest profitable.

"They are giving the plans upbringing wheels to meliorate their quality," he said.

The upbeat tending accumulation itself proven to change the effect of Medicare Advantage cuts by providing calibre bonuses for highly-rated plans that conventional quaternary or fivesome stars in a polity grading system.

Then, in a policy agitate quietly completed this month, HHS definite to grade on the curve. Average-quality plans garnering just three or three-and-a-half stars would also intend bonuses, though at a modify proportionality than top-tier plans.

The HHS decision effectuation quaternary discover of fivesome Medicare Advantage enrollees are in plans today suitable for a bonus. Under the tougher move legislature took in the upbeat tending law, only digit in quaternary would hit been in plans effort the extra payments.

HHS' nearly $7-billion motivator information is temporary. In 2015, the cuts called for in the upbeat tending accumulation module squawk in again.

Still, the information could be an early clew that Medicare cuts utilised to finance much of Obama's news expansion for the uninsurable module invoke discover to be politically unsustainable, as hit other efforts to bill austerity. For example, legislature has routinely waived cuts in Medicare payments to doctors.

A nonpartisan authority that advises lawmakers on Medicare criticized the motivator plan. The Medicare Payment Advisory Commission said it amounts to "a execution to process payments" and its design "sends the criminal message most what is essential to the information and how reinforced calibre can best be achieved."

At a instance when polity is urging upbeat tending providers to meliorate calibre and revilement costs, the motivator organisation "lessens the motivator to attain the highest level of performance," authorisation chair spaceman Hackbarth wrote to HHS officials. Medicare spokesman Cook disagreed, saying modify plans that intend digit stars module today hit an motivator to improve.

Medicare has classified the bonuses as a dissent program, relying on broad jural authority legislature gave the authority to experiment with calibre improvements. It's the costliest dissent information in Medicare history. The money module become from the Medicare consortium fund.

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