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Senator Baucus and CMS Slam Humana

In light of the recent letters sent out to their Medicare Advantage beneficiaries, insurance company Humana now faces the possibility of heavy fines and may even be kicked out of the Medicare Advantage market by federal healthcare agency, CMS. This seems like a pretty harsh penalty for a one page letter informing seniors that “health reform proposals being considered in Washington, D.C., this summer include billions in Medicare Advantage funding cuts” and that “millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable.” So why is CMS so up in arms?

At the urging of Senate Finance chairman Max Baucus who describes Humana’s letters as “mislead[ing] seniors regarding the subject,” CMS ordered Humana to stop sending out such letters. Both Baucus and CMS have put a warning to Humana and any other insurer that might get mixed up in health care reform politics, Baucus stating “it is wholly unacceptable for insurance companies to mislead seniors,” but, as the Wall Street Journal points out, “Humana merely made the mistake of trying to tell seniors the truth about what will happen to their coverage.”

CMS does not currently have a model for how insurance companies should respond to health care politics but, clearly, attempting to inform your current customers is not allowed. It should be noted that Humana has been extremely supportive of health care reform, save these changes to Medicare Advantage, despite all the fingers pointed at the insurance companies and their growing reputation as the “bad guys.” Finally, Humana attempts to defend itself through these letters, pointing out that if benefits were to be cut, it is not a consequence of Humana’s actions, but of the government. But Humana gets slammed.

Rather than arguing over words, Senator Baucus should set reimbursement levels for Humana and other managed care providers, so that they perform the way they were intended to! Save the government and taxpayers money, while offering high quality health plans. Humana should stop the clumsy PR campaign and defend their program with how they help taxpayers and beneficiaries—not simply scaring their members—be their claims true or not.

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