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CMS probes Humana's lobbying tactics on reform

A federal inquiry at the behest of a key Democratic lawmaker into an insurance company's attempt to influence the health system reform debate has prompted a groundswell of criticism from GOP leaders, who likened the government's actions to a "gag order" on reform critics. At the urging of Senate Finance Committee Chair Max Baucus (D, Mont.), the Centers for Medicare & Medicaid Services is investigating Louisville, Ky., based Humana for allegedly sending misleading information to its Medicare Advantage beneficiaries. CMS says the insurer may havemade false claims about the impact that pending health reform legislation could have on the coverage status of beneficiaries. "CMS is concerned that, among other things, this information is misleading and confusing to beneficiaries [and] represents information to beneficiaries as official communications about the Medicare Advantage program," the agency stated in a Sept. 18 letter to Humana. "As we continue our research into this issue, we are instructing you to end immediately all such mailings to beneficiaries and to remove any related materials directed to Medicare enrollees from your Web site." Baucus condemned Humana's lobbying strategy as "scare tactics" designed to convince seniors that they will lose their Medicare Advantage benefits if pending reforms are approved. "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." CMS took the issue a step further in a Sept. 21 letter to all Medicare Advantage plans, expressing concerns about the rhetoric in recent plan mailings and instructing them to discontinue communications that could be misleading. Humana has terminated its mailings and said it is cooperating with CMS, but the insurer insists it did nothing wrong. "We reviewed CMS guidance and believe the informational and educational materials we sent out did not require a filing with the agency," said Jim Turner, a Humana spokesman. "We also believe ... members deserve to know the impact that funding cuts of the magnitude being discussed would have on benefits and premiums." Republican reaction The health system reform bill proposed by Baucus would trim more than $100 billion over 10 years from the Medicare Advantage program and reduce additional funding from elsewhere in the program. Baucus does not call these trims cuts but instead calls them payment reforms that improve the overall value of Medicare. Republicans seized on the Baucus complaint and the subsequent Humana investigation, calling into question whether the insurer's freedom of speech rights are being denied because it opposes provisions in the senator's bill. "It is outrageous that the Obama administration is trying to keep seniors in the dark about the consequences of congressional Democrats' costly government-run health care bills," said House Minority Leader John Boehner (R, Ohio). "Would the administration impose this sort of gag order if seniors were being given information promoting the Obama health care plan? I don't think so." Rep. Wally Herger (R, Calif.) accused the White House of "Chicago-style politics" that go against the president's call for an open and transparent debate. "It's time to remind the president and CMS that all Americans have a constitutional right to speak their mind -- even when that holds back a government takeover of health care," Herger said. Top Senate Republicans -- including Charles Grassley (R, Iowa), Mike Enzi (R, Wyo.) and Mitch McConnell (R, Ky.) -- sent a Sept. 24 letter to Health and Human Services Secretary Kathleen Sebelius stating that "until your department rescinds its gag order and allows seniors to receive information about matters before Congress, we will not consent to time agreements on the confirmation of any nominees to your department or associated agencies." AHIP, AARP join the fight America's Health Insurance Plans also described the CMS warning to insurers as a gag order, and it reiterated that cuts to Medicare Advantage "will have a devastating impact on the health security" of seniors enrolled in the program. Some GOP lawmakers claimed CMS was playing political favorites by admonishing Humana while allowing AARP to promote reform to its members without repercussions. "I have never seen anything like this, and I question if politics was the deciding factor," said Rep. Dave Camp (R, Mich.), the top Republican on the House Ways and Means Committee. CMS "allowed misinformation to be spread by a Medicare Advantage plan sponsor, AARP, who supports the president's goal to cut $500 billion from Medicare. That kind of abuse of power cannot go unchecked." But AARP Executive Vice President Nancy LeaMond said in a statement that the organization "does not sell insurance," though it does lend its name to products made available by several insurance providers. "Our advocacy has included fighting to protect people in Medicare from egregious insurance marketing tactics," LeaMond said. "AARP's efforts to move health care reform forward should in no way be confused with the attempts by some insurers to put up roadblocks to health care reform." The full and original article can be found here: http://www.ama-assn.org/amednews/2009/10/05/gvsa1005.htm
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