Health Insurance - New guidance to insurance companies regarding Medicare mailings - 27/09/2009

Medicare recently informed contracted prescription drug and health insurance plans to suspend mailings to beneficiaries regarding, insurance reform and healthcare that could be misleading.

A number of centres for Medicare, including Medicaid Services (CMS), asked Humana Inc to stop similar mailings.

The acting director of CMS’ Centre for Health Plan and Drug Choices, Jonathan Blum, said that they were concerned that the materials sent to beneficiaries by Humana maybe violating the rules by Medicare.

Instead, they appear to contain information regarding Medicare Advantage and even prescription drug benefits which would have to be reviewed by CMS.

He also said that CMS was asking other plan sponsors to stop mailing similar material while they investigate whether or not there has been a potential violation.

Humana is just one of the numerous private health plans which contracts with CMS in order to provide drug coverage and health care services to Medicare beneficiaries as a part of Part D and Medicare Advantage programs. CMS recently found mailings, through which Humana contacted those enrolled in one or more plans and made claims that Medicare was being affected by present health care reform legislations that could affect Medicare beneficiaries.

The message Humana has sent Medicare beneficiaries is urging them to get in touch with their congressional representatives and protest actions that are referenced in the letter. CMS is investigating whether Humana improperly used lists of Medicare beneficiaries for unauthorised reasons.

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