You know, CMS has really let this Medicare Advantage program expand to a point that I don't think anyone ever anticipated.

What mechanisms are in place to hold the Medicare Advantage plans accountable for the Two-Midnight Rule?

I do think that we need to have more official information coming from CMS.

Would you say that the complexity of the system is disadvantaging people on lower incomes?

I think there is a common thing in marketing that you have to get a message out seven times before people start remembering it.

I mean, do you have an opinion on what we could be doing better as far as trying to help people?

We need to reevaluate the rules on this program, one of those being that there is a rule in place that CMS can't step in and set a floor for the base payment rate.

You can't go back to the Medicare supplement plans.

Yes. Well, the good news is you have got five years to research it. It may take that much time.

A thousand dollars a day.

I know that there are even people you can hire to help you, right.

That would have to be done at the Federal level, and CMS would have that.

As the population in the United States ages it is vital that we take a closer look at the institutions and programs that we trust to take care of our older folks.

We appreciate that Senator Ricketts has cosponsored this important legislation.

Would you say then your evaluation of this, your assessment is we actually have not met that goal, that we are not being as preventative and we are not actually saving costs in this program?

I would like to thank Senator Ricketts for leading the Improving Measurements of Loneliness and Isolation Act and for co-sponsoring the Alleviating Barriers for Caregivers Act.

Would it have been helpful to start having that dialog earlier?

How could you even anticipate that?