MA Marketing Rules Proposed
The Bush administration proposes new marketing rules for Medicare Advantage comprehensive coverage and drug plans that aim to curb aggressive sales tactics. Health insurers have received criticism for aggressive marketing tactics, which sometimes lead to beneficiaries losing supplemental coverage or access to their physicians. The proposal would prohibit cold-calling, door-to-door marketing and unsolicited marketing; ban cross-selling of non-health care products; increase the ability of CMS to fine insurers that do not comply with the rules; limit to $15 gifts and promotional items for potential customers; bar insurers from paying agents higher bonuses or commissions for the first-year enrollment of a beneficiary compared to a renewal; and add new restrictions on special needs plans. CMS officials say that they hope to issue a final rule by the end of October to allow time for the changes to take effect before the next open enrollment period begins.
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SCHIP Policy Clarification
The Bush administration sends letters to state health officials to clarify a policy directive issued last year that restricts the ability of states to expand their SCHIP programs. According to the directive, states must demonstrate that they have enrolled in their SCHIP programs at least 95% of eligible children in families with annual incomes less than 200% of the federal poverty level before they can expand eligibility to children in families with incomes more than 250% of the poverty level. The letter will qualify many of the states that did not meet the 95% requirement through the use of the data from the Current Population Survey. According to the letter, states can use data on Medicaid, SCHIP or private health insurance to demonstrate that they have reached the 95% requirement. The effect that the letter will have on states remains undetermined, according to observers.
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Quitters Sometimes Win
Women who quit smoking receive significant health benefits within the first five years of cessation, although damage caused by smoking can take decades to correct, according to a study published in the Journal of the American Medical Association. For the study, Stacey Kenfield of the Harvard School of Public Health and colleagues examined data from an ongoing study that has tracked the medical histories of more than 121,000 women since 1976. Women who quit smoking had a 13% reduction in risk for death from all causes within the first five years of cessation and had the same risk as those who did not smoke after 20 years, the study finds. After the first five years of cessation, women who quit smoking reduced their risk for death from a heart attack by 47% and their risk for death from lung cancer by 21%, according to the study.
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Going to Emergency
Emergency departments in seven U.S. cities could not adequately respond to a terrorist attack, and proposed Medicaid regulations would further limit their preparedness, according to a report presented by House Committee on Oversight and Government Reform Democrats. Committee Democrats presented the report -- which examined the ability of 34 EDs to reports to an influx of patients injured in a terrorist attack in Chicago, Denver, Houston, Los Angeles, Minneapolis, New York City and Washington, D.C. -- as part of a two-day hearing on hospital preparedness. According to the report, the EDs lacked the space to accommodate an influx of patients. The report also finds that the hospitals lacked an adequate number of intensive care unit and regular beds. HHS Secretary Mike Leavitt and Department of Homeland Security Secretary Michael Chertoff plan to testify at the hearing on Wednesday.
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Medicare Plan Marketing
State officials plan to ask Congress for more regulatory authority over the marketing of private Medicare prescription drug and Medicare Advantage plans to respond to continued complaints of aggressive practices. In a draft report by the National Association of Insurance Commissioners, state officials propose a set of marketing standards for private Medicare plans that states could enforce. The report states that the "current federal regulatory framework does not adequately protect consumers from marketing and sales abuses" and that states cannot help the Medicare beneficiaries who report complaints because the federal government has jurisdiction.
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