TSCL's surveys have found that moving Medicare Part D to a pricing system that has similarities with Medicaid has strong support among older adults. Seventy percent of those who participated in our 2019 Senior Survey support allowing Medicare to negotiate prices for prescription drugs using a similar system to Medicaid's. .In the past, supplemental benefits offered by MA plans were only required to be primarily health related and typically included dental, hearing or vision benefits. Starting in 2019, new supplemental benefits must be medically appropriate and recommended by a licensed provider as part of a care plan, and not offered simply to induce enrollment. Examples of the new supplemental benefits include adult day care services, in-home support services, home and bathroom safety devices, transportation, and home-based palliative care. However, to qualify for these benefits, you must be diagnosed with a condition for which these benefits are necessary, and the benefits must be listed by your physician as part of your plan of care. .The savings to the government for switching to the more slowly-growing CPI compound over time, and are substantial. The Congressional Budget Office estimates that the change would cut COLAs by 2 billion from 2012021 alone and, if used in other federal retirement programs and for indexing taxes as well, would reduce deficits by about 0 billion over the next decade, including reduced interest on the debt. .On Wednesday, the Board of Trustees – along with Shannon Benton (Executive Director), former Congressman Van Hilleary (Legislative Consultant), and TSCL's staff – spent the day meeting with four Congressional offices. Support was expressed for a number of bills that would strengthen Social Security benefits for older Americans, including the CPI-E Act (H.R. 3961), the CPI for Seniors Act (H.R. 3074), and the Honesty in CPI Reporting Act (H.R. 3500). .Medicare Advantage plans contract with Medicare to provide all basic Medicare services, and plans receive monthly lump sum payments that cover expected costs for an average Medicare beneficiary. But officials have known for years that some Medicare Advantage plans overbill the government by exaggerating how sick their patients are, or by charging Medicare for treating serious medical conditions that they cannot prove that patients have. Audits of 37 health plans revealed that, on average, auditors could confirm only 60% of the more than 20,000 medical conditions that CMS paid plans to treat. .TSCL's Endorsement Sought for Social Security Bill .Both the SSA and AARP say that "fixing" the Notch would be a costly mistake that would drain dollars from the Social Security Trust Fund reserve. In 1992 one popular piece of legislation to provide improved monthly benefits was estimated to cost 0 billion. To counter these concerns, alternative "capped-cost" legislation has been introduced. "The Notch Fairness Act of 2001" would provide those born from 1917 through 1926 their choice of either improved monthly benefits, or a Lump-Sum of ,000 payable over a four-year period. The cost of Lump-Sum legislation is estimated to be billion, or slightly less than .25 billion per year over a four-year period. .The alternative to this approach is control by a board of unelected bureaucrats known as the Independent Payment Advisory Board (IPAB). This board will consist of 15 unelected, unaccountable bureaucrats empowered to make decisions about what kind of care people on Medicare can receive. I am greatly concerned that this board is being given way too much authority to determine what benefits are covered and how much physicians are paid. This commission's sole intention will be to determine whether Medicare is spending more than is budgeted and, if so, to offer "fixes" to cut back on Medicare spending that would then be fast-tracked with very little opportunity for Congressional input. President Obama's former Budget Director Peter Orszag called IPAB "the single biggest yielding of power to an independent entity since the creation of the federal reserve." I believe the best way to control costs in Medicare is to increase choice and competition, not cede control of health care decisions to a board of 15 unelected, unaccountable bureaucrats. .Let's be clear about this, this is the responsibility of the Ways and Means Committee, and specifically this subcommittee.