This week the U.S. Health and Human Services Department (HHS) cracked down on Medicare Advantage (MA) organizations for their “massive misinformation campaigns” to beneficiaries. A recent article in the Huffington Post specifically highlights Humana and the letter (PDF) they sent last week to their plan enrollees claiming that Congress and the President are considering proposals to cut “important benefits and services” of Medicare, thereby jeapardizing their coverage.
HHS has mandated Humana to cease all such mailings and to remove any such information from their website immediately.
Medicare Advantage (MA) plans are specifically barred from using plan-related communications to lobby for policies or legislation. They are also supposed to only talk about an enrollee’s current benefits, or determined benefit changes that are soon to occur, not about changes that may occur.
The Centers for Medicare and Medicaid Services (CMS) sent an official memorandum to all MA organizations and Medicare Advantage Prescription Drug (MA-PD) organizations stating:
CMS has recently learned that some Medicare Advantage (MA) organizations have contacted enrollees alleging that current health care reform legislation affecting Medicare could hurt seniors and disabled individuals who could lose important benefits and services as a result of the legislation. The communications make several other claims about the legislation and how it will be detrimental to enrollees, ultimately urging enrollees to contact their congressional representatives to protest the proposals referenced in the letter.
Our priority is ensuring that accurate and clear information about the MA program is available to our beneficiaries. Thus, we are concerned about the recent mailings as they claim to convey legitimate Medicare program information about an individual’s specific benefits or other plan information but instead offer misleading and/or confusing opinion and conjecture by the plan about the effect of health care reform legislation on the MA program and other information unrelated to a beneficiary’s specific benefits.
David Lipschutz, our staff attorney, who has often voiced concern on the way Medicare providers communicate with Medicare plan members about political matters, said that: “While recent examples are more blatant than in the past, over the last few years the insurance industry has tried to convince Medicare private plan enrollees to join ‘grassroots’ organizations that are designed to protest any cuts to Medicare Advantage plan payments, sometimes using misleading and/or inaccurate rhetoric. We hope that this broader practice is also prohibited.”
If you hear of any other plans sending similar letters and messages to beneficiaries as Humana, please let us know. You can contact David Lipschutz directly at.