U.S.: Insurance Co.'s Claims on Reform "Misleading"

By: Stephanie Condon
Topics: Health Care

5192102Medicare officials are warning the insurance company Humana that it may be breaking federal regulations by sending letters to its beneficiaries that falsely claim seniors would lose benefits in the Medicare Advantage program because of Democrats' health care reforms.

The Centers for Medicare and Medicaid Services (CMS), which is part of the Department of Health and Human Services, sent a letter (PDF) to Humana, Inc. on Friday instructing the company to immediately end all such mailings to beneficiaries and to remove any related materials from its Web site. The CMS began an investigation into Humana's mailings at the urging of Sen. Max Baucus (D-Mont.), who is writing the health care legislation under attack.

"CMS is concerned that, among other things, this information is misleading and confusing to beneficiaries, represents information to beneficiaries as official communications about the Medicare Advantage program, and is potentially contrary to federal regulations," the letter to Humana said.

According to the CMS, Human sent its beneficiaries a mailer claiming that current health care reform legislation affecting Medicare could hurt "millions of seniors and disabled individuals [who] could lose many of the important benefits and services [emphasis in original document] that make Medicare advantage health plans so valuable." The mailer urges enrollees to contact their congressional representatives to protest the proposed legislative changes.

Baucus asked for an agency review of Humana's mailer last week.

"It is wholly unacceptable for insurance companies to mislead seniors regarding any subject – particularly on a subject as important to them, and to the nation, as health care reform," Baucus said in a statement today. "From lower prescription drug costs to free preventive care to better treatment for chronic conditions, seniors have so much to gain from health reform and I'm not going to let insurance company profits stand in the way of improving Medicare for seniors."

Humana is cooperating with the investigation and stopped the mailer earlier this month, a company spokesman told the Associated Press.

The proposed legislation would cut Medicare and Medicaid spending by about $500 billion over 10 years, but Baucus and President Obama contend that money will come from cutting waste and fraud currently bloating the programs -- not from cutting benefits.

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Stephanie Condon
Stephanie Condon is a political reporter for CBSNews.com.
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by Parsifal_tx September 22, 2009 4:42 PM EDT: I bet you that Hugo Chavez is smirking and giving Baucus a thumbs up right now.; Reply to this comment


by garth_o September 22, 2009 11:41 AM EDT: It is about time that someone (thanks Humana) started talking about this. The President has, at every opportunity said that getting rid of the waste in Medicare by ending these "subsidies" to Medicare Advantage plans will not reduce anyone's benefits under Medicare. Technically true, but bull nevertheless. No one would lose their benefits under original Medicare, but they do stand to lose the additional and/or increased benefits they receive under their Medicare Advantage plans. That's why they call them Medicare Advantage plans. The so-called "subsidies" largely go to pay for increased benefits. At least that is the intention.

Now, maybe we can't afford them. That's another question, but we can't answer it if we don't have the discussion. And it is obvious President Obama and now Senator Baucus do not want to have it. They want to avoid it, and let 11 million poorer, older Americans who have Medicare Advantage plans suffer the consequences.; Reply to this comment


by Realityislost September 22, 2009 11:28 AM EDT: You scare me brianbwb. The fact that reality can be so easily dismissed by so many people... This administration is a band of thugs; do things our way or we will crush you. Scary times we're living in!; Reply to this comment

by esq1991 September 21, 2009 6:29 PM EDT

I just read the flyer. It looks like they are not saying anything that is not true and a possibility. Is this any different than Obama getting on TV and scaring people about healthcare? Scaring people to push through his budget and stimulus? He does the same thing. Oh, and if Obama wants "honesty" (a word I don't think he understands), I just heard him in one of his interviews talk about insurance company profits. Why doesn't he tell the American people what their rate of return is and the fact that it is lower than beer and beverages, I believe, and probably lower than those Hollywood stars who love him so much.

Reply to this comment


by brianbwb-2009 September 21, 2009 8:20 PM EDT: Firstly, because the honest truth is that it doesn't matter what their rate of return is, they went into the business voluntarily.

The free enterprise capitalism principle says if the return is not enough, then find another business, or accept whatever comes from the one in which you invest.

When the companies can afford to throw hundreds of millions of dollars into fear mongering, bribery of politicians, and the ridiculous overpayment of executive salaries, and after that, still pay stock dividends at all, this indicates that they make more than enough profit, regardless of what beer and cigarettes make.

Also the profits from beer and cigarettes comes from people voluntarily spending money on the activity of their own choosing, while the insurance companies' profits come from the sick and dying, who have no choice, because the industry has colluded to fix prices.

You want them to make as much blood money as another industry makes discretionary money. Apparently you are a believer in communism for corporations, and a non-believer in the intrinsic value of other people.

As for "Hollywood" stars, for every "Hollywood" employee who succeeds in entertaining (an honorable profession, more honorable than betting on people's health, then welshing when you lose the bet, the standard M.O. of insurance) to the point where they become rich, there are at least 100,000 who don't, so the average "rate of return" in the entertainment industry is actually lower than the national average for labor.


by brianbwb-2009 September 21, 2009 8:20 PM EDT: Firstly, because the honest truth is that it doesn't matter what their rate of return is, they went into the business voluntarily.

The free enterprise capitalism principle says if the return is not enough, then find another business, or accept whatever comes from the one in which you invest.

When the companies can afford to throw hundreds of millions of dollars into fear mongering, bribery of politicians, and the ridiculous overpayment of executive salaries, and after that, still pay stock dividends at all, this indicates that they make more than enough profit, regardless of what beer and cigarettes make.

Also the profits from beer and cigarettes comes from people voluntarily spending money on the activity of their own choosing, while the insurance companies' profits come from the sick and dying, who have no choice, because the industry has colluded to fix prices.

You want them to make as much blood money as another industry makes discretionary money. Apparently you are a believer in communism for corporations, and a non-believer in the intrinsic value of other people.

As for "Hollywood" stars, for every "Hollywood" employee who succeeds in entertaining (an honorable profession, more honorable than betting on people's health, then welshing when you lose the bet, the standard M.O. of insurance) to the point where they become rich, there are at least 100,000 who don't, so the average "rate of return" in the entertainment industry is actually lower than the national average for labor.

by esq1991 September 21, 2009 6:22 PM EDT

I really cannot believe what I am reading. How dare he and Congress tell an insurance company not to issue communication of their opinion on the bill! Just because someone's interpretation of the proposed law does not jive with the anointed one's and his minions', then it must be wrong? Just because someone says something to disagree with Obama and the liberal Congress, we have the right to be investigated and told to stop? I am so angry and aghast, I don't know where to begin.

We have the right to speak up and I hope that if they go after Humana, Humana has enough guts to stand up to this socialist and fight. We have free speech, and even if they were not accurate in their assessment (I would say it is Obama who is lying), there is nothing in our CONSTITUTION that says they cannot say it.

This is clearly censorship of free speech and we should not stand for this any more. He is going too far. I am saying that he is the one that is lying. No, his bill does not say specifically certain things, but anybody with intelligence who can figure out the practical effect of the bill can understand what will happen. Maybe he's not used to dealing with people like that. He has been dealing with stupid ACORN people for too long; people who just buy into whatever the anointed one says without question because they don't have the intelligence to form an independent thought.

Sorry, big O, but there are a bunch of us who aren't ACORNS who do know how to figure it out and who see that the emperor of this country has no clothes.

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by brianbwb-2009 September 21, 2009 7:59 PM EDT: Does the letter state clearly that it is an opinion?

Does the company say in it that "they think", or "they believe" that the aforementioned negative effects stated will occur?

No. According to the article, it is stated as fact, when it is, as you say, only an opinion.

But then again, neos have a habit of pretending their opinions are facts.

Your "figuring out", is nothing more than making an opinion based on what you think you have read, and even here you are trying to posit your opinion as fact.

P
Here is proof, the article states that "...Baucus asked for an agency review of Humana's mailer last week...." , yet you are still vomiting hate about the President and ACORN, as if it is the grassroots organization and the president that asked for the review.

Baucus is not ACORN, neither is President Obama.

Freedom of speech has, at long last been welded to responsibility of speech, and since the opinions expressed in the mailer are unproven speculation masquerading as fact, it is the responsibility of an organization that affects the lives of seniors not to lie about it, and if they do they should be called on their lies.

Just as I have called you on yours.


by Parsifal_tx September 23, 2009 8:54 PM EDT: I got a copy of the Humana letter.

"Dear MEMBER:

With the media reporting daily on Congress? and President Obama?s efforts to enact meaningful health reforms this year, many Humana Medicare Advantage (MA) members are contacting us with questions. Members just like you want to know what these reforms might mean for their Medicare health plan and how they can get involved to help protect Medicare Advantage.

We are working diligently to ensure that our nation?s leaders understand how proposed reforms might affect you. At the same time, we have created the Partner program to keep you informed about proposed Medicare changes and help you get involved so your voice is heard in Washington. Your opinions matter to us, to others on Medicare, and to your elected officials. There are two things you can do now to help show Congress the importance of Medicare Advantage:

? Opt into the Partner program. Becoming a Partner is easy. Just complete the accompanying, postage-paid form and follow the instructions to fold and mail it back. As a Humana Partner, you will join more than 50,000 Humana Medicare Advantage members who are receiving information about this issue and learning how to get involved to protect your Medicare health plan coverage.

? Let your Members of Congress know why Medicare Advantage is important to you. Congress is considering significant cuts to Medicare Advantage now, and your Members of Congress will want to know why this program is valuable to you because these cuts could mean higher costs and benefit reductions to many on Medicare Advantage.

We?ve made it easy for you to have your voice heard. Just call (877) 698-9228 (toll-free) or visitwww.humanapartners.com for additional information about this issue and how you can offer helpful input to your elected officials.

Leading health reform proposals being considered in Washington, D.C., this summer include billions in Medicare Advantage funding cuts, as well as spending reductions to original Medicare and Medicaid. While these programs need to be made more efficient, if the proposed funding cut levels become law, millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable.

On behalf of Humana?s 28,000 employees, I would like to thank you for being a Humana member. We look forward to partnering with you to ensure the Medicare Advantage program remains strong, so you can have peace of mind about your health coverage?now and in the future!

Regards,
Philip Painter, M.D.
Chief Medical Officer
Humana Medicare"