Wednesday, September 23, 2009

Humana Gag Order: Abuse of Power or Warranted?

Humana is under investigation for sending out communication to their Medicare Advantage clients. The Huffington Post obtained a copy of the Humana mailing and can be viewed here: I read the mailing sent by Humana and found nothing outlandish or misrepresentative of the reform being discussed on Capitol Hill but I suggest everyone to read the mailing to judge for themselves. The mailing does warn that "Some in Washington want to cut billions of dollars out of the Medicare Advantage program" and outlines changes that Humana will be forced to make if the cuts take place. Sen. Baucus took exception to Humana's mailer to their clients. "It is wholly inappropriate 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. The health-care reform bill we released last week strengthens Medicare and does not cut benefits covered under the Medicare program – and seniors need to know that," stated Sen. Baucus.

While I agree with Sen. Baucus that no company ought to mislead the public, did Sen. Baucus forget what was written in his bill? The bill calls for $123B in cuts to Medicare Advantage over the next ten years. Instead of recalling this fact Sen. Baucus complained to the Centers for Medicare and Medicaid Services (CMS). The CMS in turn ordered Humana on last Friday to cease and desist because their mailer was "misleading and confusing". Again, I suggest everyone to read it. The kicker is that Humana, and others, have supported ObamaCare with the exception of Advantage cuts and the public option (Wall Street Journal). So, why the gag order Sen. Baucus?

Americans see the warning here? The complaint by Sen. Baucus is a prime example why Government cannot be a participant and referee in any industry. Filing the complaint to the CMS is an abuse of power and a blatant attempt to restrict the communication of what is going on in Congress. The America's Health Insurance Plans, an industry trade group, expressed their outrage to the gag order by saying that proposed cuts "will have a devastating impact on the health security of the more than 10 million seniors enrolled in the program. 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" ( Again, why is the Obama Administration allowing a gag order on information being sent out to those that are impacted?

The Medicare Advantage program receives additional reimbursement rate which cost taxpayers an additional 14% per enrollee ( Now if Sen. Baucus cuts ($123B) or President Obama cuts ($177B) to Medicare Advantage rates takes place the logic step of those provided the insurance option will need to cut back benefits in order to maintain margin expectations. All Humana, as I can tell from reading the mailer, is guilty of is warning their clients of how changes in reimbursement rates will affect their coverage. If Sen. Baucus or President Obama has trouble with that then offer an explanation on how Humana is incorrect in their assessment. Do not sick the CMS on them or others in the insurance industry to place a gag order on them. It is their right to communicate to their clients.

Don't take my assessment as gospel; rather read the mailer (link above) and determine for yourself if Humana violated any laws as to stating any misleading or confusing information. After you read it and make your own assessment call your Senators and Representative to voice your opinion. I wonder how long the CMS will take to determine if laws were violated.