Humana Protests 'Gag' Order In Health Care Reform Dispute

NU Online News Service, Sept. 22, 2:33 p.m. EDT

WASHINGTON–A health insurance plans trade group assailed the Centers for Medicare and Medicaid Services today after the agency ordered Medicare Advantage providers to suspend what it says are misleading mailings about health care and insurance reform.

America's Health Insurance Plans decried what it called a "gag order."

Jonathan Blum, acting director of CMS' Center for Drug and Health Plan Choices, noted mailings by the Humana group that stated that if health care reform legislation as currently drafted, goes through, the Medicare Advantage program may be eliminated.

In his comments, Mr. Blum said that Humana has agreed to suspend the mailings to Medicare Advantage recipients.

"We are concerned that the materials Humana sent to our beneficiaries may violate Medicare rules by appearing to contain Medicare Advantage and prescription drug benefit information," Mr. Blum said. He said that such information "must be submitted to CMS for review."

The portion of his statement which angered the American Health Insurance Plans, was, "We also are asking that no other plan sponsors are mailing similar materials while we investigate whether a potential violation has occurred."

Mr. Blum made clear that Humana, and by implication, other MA providers who send such mailings, could be subject to "appropriate compliance and enforcement actions."

But Robert Zirkelbach, a spokesman for America's Health Insurance Plans, said the decision to ban mailings was unfair.

He said that the current health care reform proposals include more than $100 billion in cuts to Medicare Advantage that he argued "will have a devastating impact on the health security of the more than 10 millions seniors enrolled in the program."

Mr. Zirkelbach added, "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."

But a healthcare industry analyst who asked not to be named said he believes the Medicare Advantage providers are just overreacting.

"CMS has just told the providers to stop sending out propaganda," the analyst said. "This is an old insurance industry trick."