WASHINGTON BUREAU — The U.S. Government Accountability Office says the Centers for Medicare and Medicaid Services (CMS) followed the rules but took an “unusual” action when it told health carriers to stop mailing Medicare Advantage plan enrollees warnings about pending legislation.
The GAO today released a report developed in response to questions from Republican House members about the decision by CMS to order Humana Inc., Louisville, Ky. (NYSE:HUM), to stop sending Medicare Advantage (MA) plan enrollees warnings about what the proposed program changes might do to their coverage.
CMS also told other large Medicare Advantage carriers to stop communicating with enrollees about pending legislation.
“In general, CMS’s handling of MA communications on pending health reform legislation appeared to adhere to the agency’s policies and procedures,” GAO officials say in the report.
The Sept. 21, 2009, CMS memo instructing all Medicare Advantage organizations to discontinue communications on pending legislation while CMS conducted its investigation “was unusual,” officials say.
Representatives from CMS and Humana were not immediately available for comment.
GAO officials say Medicare Advantage plan and CMS regional staffers “told us they were unaware of CMS ever directing all MA organizations to immediately stop an activity before CMS had determined whether that activity violated federal laws, regulations, or MA program guidance.”