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As Medicare Enrollment Period Draws to a Close, MA Steering Continues – Advocates & Members of Congress Write Letters of Concern to CMS || Center for Medicare Advocacy

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As we strategy the ultimate week of the Medicare Annual Coordinated Election Period (ACEP), people proceed to make selections about how they need to entry their Medicare advantages in 2019.  Shopper advocates are involved, nevertheless, that the knowledge put out by the Medicare program about protection choices is incomplete and continues to promote one choice over one other.

As mentioned under, the Middle for Medicare Advocacy and the Medicare Rights Middle lately wrote to the Facilities for Medicare & Medicaid Providers (CMS) expressing ongoing considerations about schooling and outreach supplies for the present ACEP which collectively act to promote Medicare Benefit (MA) over conventional Medicare.

Background

The Medicare statute obligates the Secretary of Well being and Human Providers, and, by extension, CMS, to present and promote correct details about the Medicare program.  For instance, 42 U.S. Code §1395w-21(d)(1) states: “The Secretary shall present for actions underneath this subsection to broadly disseminate info to Medicare beneficiaries (and potential Medicare beneficiaries) on the protection choices offered underneath this part so as to promote an lively, knowledgeable choice amongst such choices. [Emphasis added.]

Within the Fall of 2017, beneficiary advocates started to increase considerations with CMS that, opposite to prior iterations, its outreach and enrollment supplies inspired beneficiaries to select a personal Medicare plan over conventional Medicare as an alternative of extra objectively presenting enrollment choices.[1]  For instance, In November 2017, the Management Council of Getting older Organizations wrote CMS, urging the company “to take steps to correct misleading public outreach and education” and “take immediate corrective action to include and accurately portray the benefits and drawbacks of all coverage options in CMS materials, always including traditional Medicare as a beneficiary option.”[2] 

These considerations have been renewed when CMS launched a draft model of the 2019 Medicare & You handbook in Spring 2018.  On the time, the Middle for Medicare Advocacy, Justice in Getting older and the Medicare Rights Middle despatched a letter to the CMS elevating “strong objections to serious inaccuracies” within the draft 2019 Medicare & You Handbook, and urged CMS to rectify the errors prior to dissemination.  These errors included: strategies that MA is the inexpensive various for beneficiaries; failure to spotlight the clear distinction between conventional Medicare and MA: conventional Medicare supplies entry to all Medicare collaborating suppliers nationwide, whereas MA usually limits entry to a set community of suppliers in a particular geographic space; and characterizing prior authorization necessities in MA plans, that are restrictions on entry to providers, as a profit, moderately than as what they’re: obligatory hurdles for MA members not required for people in conventional Medicare.[3]

In June 2018, Rating Members Richard Neal and Frank Pallone, of the Home Methods & Means and Power & Commerce Committees, respectively, wrote a letter to CMS Administrator Seema Verma echoing many of the identical considerations raised by our organizations.[4]

To its credit score, CMS did reply to many of these considerations raised relating to the handbook, together with addressing some of the draft’s most critical inaccuracies and omissions within the remaining model.[5]   Nevertheless, as mentioned under, CMS continues to perpetuate the imbalance between selling MA vs. conventional Medicare via on-line instruments, emails, promoting campaigns, and different communications.[6]

Current Joint Letter to CMS with the Medicare Rights Middle

On November 16, 2018, the Middle for Medicare Advocacy (CMA) and the Medicare Rights Middle (MRC) despatched a joint letter to CMS expressing considerations with CMS’ schooling and outreach supplies for the present Medicare ACEP, “which together seem to promote Medicare Advantage (MA) over traditional Medicare.”

Particularly, the letter highlighted new CMS on-line instruments and an e mail marketing campaign focused in the direction of beneficiaries.  With respect to a suite of on-line instruments launched in October 2018 aimed toward aiding shopper decision-making, the letter said that the Examine Protection Choices device “may inappropriately and prematurely encourage individuals to enroll in MA — by making overly-broad suggestions to do so when more nuance is required, and by failing to present individuals with the full array of Medicare coverage options.”[7] [8]

Equally, the letter notes that “CMS’ current ACEP email campaign and other messaging to beneficiaries is improperly biased towards MA.”  CMS has despatched emails to beneficiaries and different stakeholders “with subject lines such as ‘Could Medicare Advantage be right for you?’ or ‘Get more benefits for your money’ start the body of text with ‘Check Out Medicare Advantage.’”  As the letter notes, “[t]hese messages make no attempt to inform beneficiaries about their coverage options under traditional Medicare, potentially preventing them from making a fully-informed choice.” Likewise, “official advertisements from the Department of Health and Human Services promote MA, without mention that enrolling in traditional Medicare is also an option during the ACEP.”[9]

Acknowledging that the 2018 ACEP is properly underway, our organizations said that “CMS can still act to achieve greater parity in its materials in the remaining weeks when many people make their enrollment decisions. Accordingly, we request that CMS act quickly to revise both its online web tools and the ACEP beneficiary outreach messages so they more equally and accurately reflect the availability of traditional Medicare coverage options.”

Congressional Letter

On November 19, 2018, virtually your complete Connecticut delegation (Rep. DeLauro, Sen. Blumenthal, Sen. Murphy, Rep. Larson, Rep. Courtney and Rep. Esty – despatched a letter to CMS “expressing our concern” that CMS “is inappropriately working to steer Medicare beneficiaries to Medicare Advantage plans.” Citing the “regular, targeted messages highlighting Medicare Advantage, but not Original Medicare, during the Open Enrollment Period.” The letter said “[i]n order to correct his imbalance, we urge you to send targeted messaged regarding Original Medicare that will match the efforts made for Medicare Advantage.”

Middle for Medicare Advocacy/Nationwide Committee to Protect Social Safety and Medicare “Fully Informed” Undertaking

Out of concern concerning the objectivity of some of CMS’ enrollment and outreach supplies,  the Middle for Medicare Advocacy and the Nationwide Committee to Protect Social Safety and Medicare have partnered to develop an schooling and outreach undertaking to help Medicare beneficiaries and people who help them enroll and re-enroll in Medicare. The Medicare Absolutely Knowledgeable Challenge offers a selection of unbiased, correct and complete details about the complete vary of Medicare protection choices, and consists of an array of instruments to help in making the most effective particular person enrollment decisions.[10]

Conclusion

Making knowledgeable selections about how one needs to entry Medicare protection is difficult, and has grow to be extra so following a quantity of current coverage modifications, notably regarding Medicare Benefit.[11]  The Medicare program has an obligation to current info in a balanced and impartial method slightly than unduly selling one choice over one other.  We urge CMS to right this imbalance.

November 30, 2018 – D. Lipschutz


[1] See, e.g., Middle Weekly Alert (October 25, 2017): http://www.medicareadvocacy.org/cma-alert-remember-you-can-choose-original-medicare-equitable-relief-this-weeks-sabotage-news/
[2] On November 9, 2017, the Management Council of Getting old Organizations (LCAO), a member coalition of the nation’s non-profit organizations serving older People, despatched a letter about this difficulty to CMS and committees of jurisdiction in Congress. The letter is accessible right here: http://www.lcao.org/files/2017/11/LCAO-Open-Enrollment-Letter-to-CMS_11_2017.pdf.
[3] See Middle Weekly Alert (Might 31, 2018): http://www.medicareadvocacy.org/advocates-raise-concerns-about-comparisons-between-traditional-medicare-and-medicare-advantage-in-draft-2019-medicare-you-handbook/.
[4] See Middle Weekly Alert (June 21, 2018): http://www.medicareadvocacy.org/tipping-the-scales-toward-medicare-advantage-at-the-expense-of-medicare/.
[5] Letter from Justice in Ageing, Medicare Rights Middle and Middle for Medicare Advocacy to CMS Administrator Verma (October 1, 2018), out there at: http://www.medicareadvocacy.org/wp-content/uploads/2018/10/2019-Medicare-and-You-Handbook-Ltr-to-SV.pdf.    
[6] See, e.g., Middle Weekly Alert (October 5, 2018), together with evaluation of new CMS on-line instruments: http://www.medicareadvocacy.org/medicare-enrollment-updates/.
[7] See the textual content of the letter for evaluation of particular solutions to this on-line quiz.
[8] For instance, as famous in a current New England Journal of Drugs difficulty, “for some beneficiaries with high health care spending, traditional Medicare coupled with supplemental insurance has the potential to be a lower-cost alternative to Medicare Advantage”-  “Medicare Advantage Checkup” by Patricia Neuman, Sc.D., and Gretchen A. Jacobson, Ph.D., New England Journal of Drugs (November 2018), obtainable at:  https://www.nejm.org/doi/pdf/10.1056/NEJMhpr1804089. 
[9] See, e.g., HHS Video on YouTube:  https://www.youtube.com/watch?v=HwIvi2eF21Q.
[10] For extra details about this undertaking, together with supplies, see http://www.medicareadvocacy.org/medicare-fully-informed-project/.
[11] See, e.g., Dialogue part of the Middle’s” Particular Report: Current Modifications in Regulation, Laws and Steerage Relating to Medicare Benefit and the Prescription Drug Profit Program” (September 2018), obtainable at:    http://www.medicareadvocacy.org/wp-content/uploads/2018/09/Report.-Summary-2019-Call-letter-and-C-D-Rule-1.pdf.