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According to National Underwriter the Centers for Medicare and Medicaid Services (CMS) ordered all Medicare Advantage providers to suspend what it considers to be misleading mailings sent to beneficiaries about health care and health reform.

The order was sparked by a mailing campaign conducted by Humana Inc. The mailings conveyed to recipients that current health care reform legislation in Congress would eliminate the entire Medicare Advantage program.

CMS representatives state that the mailings may be in violation of Medicare rules, as Humana’s campaign assets were not submitted to CMS for approval – a requirement for any marketing piece that contains Medicare Advantage benefit information. Humana has agreed to suspend the mailings while a final decision is made.

Representatives from America’s Health Insurance Plans (AHIP) are criticizing the move as unfair and calling it a “gag order.”

Weekly Recap:

World Alzheimer’s Day: On Sept. 21, Alzheimer’s Disease International released a report stating that 5.3 million Americas have the disease. The report also forecasts that 35 million people worldwide will have dementia next year which is primarily caused by Alzheimer’s disease. The most startling fact in the report is its forecast that dementia prevalence will almost double every 20 years to 65.7 million in 2030 and 115.4 million in 2050.

Bill to Stop Part B Increase: A new house bill was introduced that aims to keep Medicare Part B premiums the same. With no Social Security benefit increase next year, an increase in Part B will effectively further reduce the income of senior citizens. The bill is sponsored by Rep. Dina Titus (NV-D), AARP, and several other senior-advocate organizations.

AA Retirees Lose Coverage: American Airlines will discontinue paying for Medicare supplement insurance for its retired, non-union employees because the cost is too high. As of January 1, non-union retirees age 65 and older will have to pay for supplement insurance themselves. Those who participated in the pre-fund program will be reimbursed. Sources: National Underwriter, Senior Journal, Dallas Morning News

On Wednesday, Senator Max Baucus (D-Montana) introduced a new bill that primarily seeks to make health care coverage mandatory, and to do so in a way that would not add to the federal deficit. What’s even more interesting is what is not in the bill – a public option. The prominent Democratic bill symbolizes how divisive an issue a public option is even among the Democratic party. Despite the lack of a public option, the bill has no Republican support.

The bill is said to cost $856 billion over 10 years and will be financed through $500 billion dollars in spending cuts, much of it coming from Medicare. An additional $350 billion will be generated through new taxes and fees. Many of the new fees are directed toward private medical companies ranging from insurance companies to medical device manufacturers to pharmaceutical companies. For the official release and details of the bill click here.

In other news:

More Seniors to Work Beyond 65: According to a study by the University of Michigan Institute for Social Research, 57% of older Americans (aged 51 and older) plan to work full-time beyond age 65 (up from 47% in 2008), while 65 plan to work past age 62 (up from 60% in 2008). The survey also found that stock investment value among older Americans declined between 20-30% in 2008.

Baby Boomers Rival Seniors for Most Costly: According to the Agency for Health Care Research, hospitals spent nearly the same to care for baby boomers (54-64) as they did for seniors (65 and older). The numbers? Baby boomers: $56 billion – Seniors: $59 billion. The average hospital stay for a baby boomer costs $11,900, with seniors slightly higher. Males in both groups saw higher hospitalization rates than females (151.7 stays per 1000 vs. 140.4 stays per 1000).

Money Talks: According to the non-partisan Public Campaign Action Fund, 14 of the biggest health insurance companies have spent roughly $200 million to influence the health care reform debate since January 2009. The figure was derived by analyzing all forms of political spending, such as campaign contributions and lobbying expenses.

Insurance Companies to Lose Anti-trust Exemption?: According to ModernHealthcare.com, Democratic politicians have introduced bills that would strike down the McCarran-Ferguson Act of 1945 that is cited by many health providers as allowing consolidation among major health insurance companies that would normally breach anti-trust laws. Similar proposals have been introduced before, but supporters are hopeful the issue will get more attention in the current political climate.

The Gerber Life Medicare supplement launch has no doubt inundated your inbox with about 50 emails regarding this product from various entities, so if you’ve made it to this page, I want to personally thank you. Like you, everyone here at PSM is seeing the famous baby face in their dreams at night with the massive amount of activity that has taken place since Tuesday. Our phones have been ringing constantly, and our website has seen 10,000 page views since the release of the product. If you haven’t seen our national press release, check it out at: http://www.prweb.com/releases/Medicare-Supplement/Gerber-Life/prweb2837364.htm If you are still on the fence about this product, we encourage you to call us to learn why this product is set to be one of the most competitive in the market. For reference here is a direct link to our Gerber Life Medicare supplement landing page with more links to rates and contracting information.

Weekly Recap:

Remembering 9/11: PSM will take a moment of silence today to honor those who lost their lives during the events of 9/11.

President Obama’s “Full-Court Press”: Beginning with addressing a joint session of Congress on Wednesday night, President Obama will be making several speeches detailing his vision for health care reform. Of course, the biggest news stemming from the speech seems to be the outburst from Joe Wilson (R-SC) who shouted “You lie” when Obama stated that his health reform vision doesn’t include coverage of illegal immigrants. Here are some of the other details stemming from the speech:

* No one will lose health insurance coverage if they already have coverage.

* Insurance companies will not be able to deny individuals coverage because of pre-existing conditions.

* Inclusion of Sen. McCain’s (R-AZ) plan to cover people without insurance if they can’t afford it and can’t wait four years until the Health Insurance Exchange is established.

* The majority of health care reform will be paid for by cutting Medicare costs.

* The most expensive insurance plans will be taxed, with the revenue paying for reform.

* Medicare malpractice reform is another possible way to pay for reform.

* A public option is not mandatory.

* Those who already have health insurance through a job, Medicare, Medicaid or the VA, will not be required to change coverage or doctors.

* Insurers will be required to cover basic checkups and preventive care.

* Health care reform will not result in euthanasia or death panels for the elderly.

* Out-of-pocket expenses will be capped.

Chronic Conditions Highest Among Elderly Women: Last week, a Health and Human Services report showed that chronic conditions are most prevalent among women because they live longer. This may seem like a no-brainer, but the report does have some very interesting quantitative data that you may find useful to present to your clients. Here are some of the most interesting points:

* Among people age 80 and older, 93% have at least one chronic condition and 78% have two more.

* The growth in Medicare Part B premiums from 2000 to 2018 is predicted to cost seniors an additional $1,577 per year out-of-pocket.

* 98% of Medicare spending is for beneficiaries with one or more chronic conditions.

* Senior women spent on average 17 percent of their income on health care in 2005.

For this and other HHS reports click here.

On Tuesday, a new Medicare Supplement product will be released by an "A" rated (A.M. Best) company that has one of the most recognizable brands among Americans of all ages. This new product is filed for approval in 32 states and will eventually roll out to even more. As an exclusive distribution partner, we look forward to releasing details on this new product on Tuesday. In the meantime, have a great Labor Day weekend!

Weekly Recap

President Obama to Speak Out on the 9th: He will give a speech on health care reform to a joint session of Congress next Wednesday in an attempt to refocus the national conversation on healthcare. NPR listed several poll results that show opposition to his health reform goals has grown. Three of the polls cited show opposition is around 50% as of the last week of August. White House officials say this speech will provide a comprehensive explanation of the President’s health care plans which have been ambiguous thus far.

The Compromise: In an effort to make some progress on the healthcare issue, President Obama and Republican Senator Olympia Snow are in serious discussions regarding a new health care reform plan. At the center of the compromise is a public healthcare option “trip wire”. Under this plan, a public option would only be implemented if certain performance criteria are not met. Another major compromise would be establishing a law barring insurance companies from denying coverage to people with pre-existing conditions. This plan is intended to win over 1 or 2 Republican votes and most of the conservative democrats.

FTC Bans Commercial Robocalls: For those of you who use autodialers or robocalls to contact consumers, you will want to take a look at this page: http://www.ftc.gov/opa/2008/08/tsr.shtm Violators of this new law will face penalties of up to $16,000 per call. After September 1, 2009, consumers who receive prerecorded telemarketing calls, but have not agreed to get them can file a complaint with the FTC who will then investigate.

Medicare Advantage/Part D Enrollment Begins Nov. 15: Medicare Advantage marketing has many requirements, so we encourage all our agents to get caught up on all the new rules to make sure the enrollment period is spent writing business and not putting out compliance fires. Contact your PSM marketer today for a list of resources where you can get the training you need.