Medicare Sets Probe of Humana Letters
Jim Higgins
http://online.wsj.com/article/SB125349705522626821.html
The Centers for Medicare and Medicaid Services launched an investigation
into Humana Inc.'s effort to enlist beneficiaries to fight proposed cuts
to Medicare's private plans.
The investigation, launched Friday, is looking at whether Humana, one of
the largest providers of Medicare Advantage plans, violated marketing
rules by sending letters to beneficiaries in Michigan, Florida and other
states urging them to contact lawmakers to register their opposition to
proposed cuts.
The letters state that "millions of seniors and disabled individuals
could lose many of the important benefits and services that make
Medicare Advantage health plans so valuable" -- a claim congressional
Democrats say is false.
CMS is also examining Humana's online Partner program, which
automatically drafts letters that people can send to their lawmakers
opposing cutbacks. Officials on Friday requested that the company stop
the mailings and shut down the Web site.
Jonathan Blum, CMS's acting director of the Center for Drug and Health
Plan Choice, said the agency "places strict limits and oversight on how
plans communicate with beneficiaries. There's a potential violation of
CMS's marketing rule." If Humana violated marketing rules, sanctions
could include fines or suspending its ability to market their plans and
enroll new beneficiaries, Mr. Blum said.
Medicare Advantage plans wrap physician and hospital services together
and often provide extra benefits such as vision coverage and
prescription drugs; unlike with traditional Medicare, the government
pays insurers to manage beneficiaries' care.
The plans currently cost the government 14% more on average per
beneficiary than traditional Medicare does.
Senate Finance Committee Chairman Max Baucus (D., Mont.) -- whose
proposal to overhaul the health-care system would cut payments to
Advantage plans by $123 billion over 10 years -- pushed for the
investigation.
"[Humana's] tactics do a disservice to beneficiaries by spreading false
claims about such an important bill in Congress," said Erin Shields, a
spokeswoman for Sen. Baucus. "Cutting the fat from the profits of
private health plans that deliver Medicare is the best way to ensure the
sustainability of the program and preserve the Medicare benefits seniors
depend upon."
Humana spokesman Tom Noland said the company is "cooperating fully with
CMS to address any concerns." The company, he said, "relied on CMS
marketing guidelines to determine whether or not to file the materials
associated with this mailing. We believed these informational and
educational materials did not require filing."
Humana supports health-care overhaul, he said, but believes that its
members "deserve to know" about the proposed cuts to the Advantage
program. "Funding cuts of that magnitude would result in lower benefits,
higher premiums and fewer choices for many of the 10 million Americans
in Medicare Advantage plans," he said.
Humana, with about 1.4 million Medicare Advantage enrollees, is the
second-biggest provider of the plans, behind UnitedHealth Group Inc. The
business accounts for about half of Humana's revenue.
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Civis Romanus Sum
Glenn
news:VaudnUnbNM4HGCrX...@posted.eaglecomputertechnology...
LIAR!
Humana should do what the NRA and insurance companies do, create
front organizations such as ILA and AARP.
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Glenn
Jean Smith
"Glenn" <min...@gmail.com> wrote:
They need to put something in the Federal Acquisition Regulations about service
providers providing nonmedical advice to their patients and disallow the
overhead.
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Occupation 101 http://video.google.com/videoplay?docid=-2451908450811690589#
Check http://politifact.com http://healthcarefactcheck.com/
http://www.healthactionnow.org/?s_src=20090622_US_E_HAN_LaunchAT
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