Home > Press Releases > Gov. Rosselló Calls For Increased Funding For Medicare Advantage In Puerto Rico

(San Juan, Puerto Rico – January 25th, 2017) Today the Governor of Puerto Rico, Hon. Ricardo Rosselló, wrote a letter to Acting-Secretary of Health and Human Services (HHS), Norris Cochran, advocating for increased funding to the Medicare Advantage (MA) plans operating in Puerto Rico which serve over 570,000 elderly island residents including some of the most vulnerable among them.

The Governor’s letter calls for meaning policy adjustments to the rates paid by the Centers for Medicare & Medicaid Services (CMS) to MA plans operating in Puerto Rico in anticipation of the February 1 release of the annual proposed payment rate notice for MA, which will be effective in 2018. He expressed his intention to collaborate with HHS in drafting proposals, “that protect and enhance funding levels in the upcoming proposed rule.”

Since 2011 changes in the MA payment formula that resulted from the Affordable Care Act have resulted in reductions payment benchmark reductions of over 20% for MA plans in Puerto Rico. Yet during the same period the U.S. average benchmark has increased by 4%. Currently the MA benchmark in Puerto Rico has fallen to 43% below the U.S. average, and 38% below the average of the lowest state Hawaii. This disproportionate reduction in MA rates in Puerto Rico is generating grave consequences for the island’s healthcare system which is already heavily strained by other significant disparities in treatment under federal healthcare programs, most notably under Medicaid. Indeed, Puerto Rico currently receives only one third of the total federal resources for healthcare when compared to the U.S. average of all states.

Governor Rosselló affirmed that addressing Puerto Rico’s Medicare and Medicaid disparities is critical not only to the viability of the island’s healthcare system, but also to its fiscal recovery and efforts to restore economic growth. Therefore, the Governor has made efforts to seek more equitable treatment for Puerto Rico under federal health care programs one of the guiding priorities of his administration. Toward that end on January 16, Governor Rosselló issued Executive Order 117-012 creating Multi-Sector Working Group on Puerto Rico’s Federal Healthcare Issues. The Working Group will hold its kick-off call today and is expected to begin in person meetings in San Juan and Washington, D.C. in the coming weeks.

  “Safeguarding the healthcare of the people of Puerto Rico is one of my top priorities and is of critical importance to the proper functioning of our economy and society. Calling on HHS and CMS to take this opportunity to address the MA funding disparity Impacting Puerto Rico is but one of the many advocacy efforts that my administration will undertake before federal officials to better meet the health care needs of island residents,” emphasized Governor Rosselló.

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For more information, contact

Pedro Cerame
Communications Director
pcerame@prfaa.pr.gov