CMS To Plans: End Mailings

September 22, 2009 at 08:00 PM
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WASHINGTON BUREAU — The Centers for Medicare and Medicaid Services has ordered all Medicare Advantage providers to "suspend" what it says are potentially misleading mailings to beneficiaries about health care and insurance reform.

Officials at America's Health Insurance Plans, Washington, are calling the CMS order a "gag order."

Jonathan Blum, acting director of the CMS' Center for Drug and Health Plan Choices, says CMS have issued the order in response to beneficiary mailings sent by Humana Inc., Louisville, Ky.

Humana warned in the mailings that health reform legislation now before Congress could eliminate the Medicare Advantage program.

Humana has agreed to suspend the mailings, Blum says in a statement.

"We are concerned that the materials Humana sent to our beneficiaries may violate Medicare rules by appearing to contain Medicare Advantage and prescription drug benefit information, which must be submitted to CMS for review," Blum says.

"We also are asking that no other plan sponsors are mailing similar materials while we investigate whether a potential violation has occurred," Blum says.

Humana could be subject to "appropriate compliance and enforcement actions" if it continues to send the kinds of mailings that it has suspended, Blum says.

Robert Zirkelbach, a spokesman for AHIP, says the decision to bar the mailings is unfair.

Current health care reform proposals could cut Medicare Advantage program funding by more than $100 billion over the next 10 years, and implementing those proposed cuts would "have a devastating impact on the health security of the more than 10 millions seniors enrolled in the program," Zirkelbach says.

"If these cuts are enacted, seniors will face premium increases, reduced benefits, and, in some parts of the country, will lose access to their Medicare Advantage plan altogether," Zirkelbach says.
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