Humana Investigated by Medicare for Deception

Humana Insurance Accused of Using Misleading Medicare Mailers

Nov 4, 2009

The Obama administration is looking into whether Humana Insurance violated Medicare marketing rules when it sent suspect mailers to Medicare Advantage policy holders.

The U.S. Health and Human Services Department (HHS) is probing a recent mailing campaign initiated by the Humana insurance conglomerate to seniors nationwide. The Humana mailers, which warned beneficiaries about alleged Medicare cuts as a result of President Obama's health care reform, posed as policy updates to Humana Medicare insurance beneficiaries, and were viewed by HHS's Center for Medicare and Medicaid Services (CMS) as both misleading and in potential violation of Medicare marketing guidelines.

CMS has since ordered Humana to cease all such mailings to Medicare insurance beneficiaries as it investigates the incident, according to Dawn Teo's Huffington Post article entitled, "HHS Investigates Medicare Providers' Massive Misinformation Campaign."

The Humana mailer, which appeared as a personalized letter to beneficiaries, appeared on the surface as a policy update to seniors. However, throughout the mailer—a copy of which can be viewed here—seniors were both warned about potential (unsubstantiated) cuts to Medicare Advantage plans and encouraged to take action.

Additionally, a separate website was created, humanaparterns.com, and seniors were encouraged to visit, join Humana insurance's information campaign, and act on behalf of Humana against proposed Medicare cuts.

Humana Insurance Tactics Possibly Violate Medicare Guidelines

According to CMS guidelines, private insurance companies are only allowed to communicate with beneficiaries about benefits that they currently have with their purchased plans. They are not, however, allowed to contact beneficiaries about theoretical or possible changes to benefits. As for political communications, CMS guidelines do not expressly address the matter, though recent actions by CMS indicate that it will not allow private insurance companies to engage in the explicit political lobbying of beneficiaries via a mailing list.

After learning of the Humana Medicare mailings, CMS sent a letter to Humana expressing its concern, an excerpt of which, obtained from Teo's article, appears below:

CMS has learned that Humana has been contacting enrollees in one or more of its plans and alleging that current health care reform legislation affecting Medicare could hurt "millions of seniors and disabled individuals [who] could lose many of the important benefits and services that make Medicare advantage health plans so valuable." The message makes several other claims about the legislation and how it will be detrimental to enrollees, ultimately urging enrollees to contact their congressional representatives to protest the actions referenced in the letter

The concern by the Obama administration is that the mailings were deceptive in that they misrepresented political lobbying and advocacy as information on Medicare benefits. An investigation into whether the Humana mailers violated Medicare marketing laws is ongoing.

Florida Seniors Denounce Humana Medicare Mailings

The mailings, which heavily targeted the state of Florida, were received poorly by members of the Florida Alliance of Retired Americans, a group with more than 200,000 members. The group's president, Tony Fransetta, wrote an open letter to Humana's CEO:

The Florida Alliance for Retired Americans denounces recent mailings to Medicare Advantage recipients. These mailings are a shameful attempt to protect your profits and they are spreading misinformation about health insurance reform. We demand that you immediately cease and desist from sending further mailings and apologize to those seniors who have received this misleading mail from Humana.

We are very disappointed and saddened at Humana's deliberate attempts to misinform Medicare Advantage recipients about health insurance reform in order to bolster your bottom line.

While additional organizations have expressed similar concern, the investigation into whether Humana actually violated Medicare insurance guidelines continues, and may take months to complete.

The copyright of the article Humana Investigated by Medicare for Deception in US State Policy is owned by David Harris-Gershon. Permission to republish Humana Investigated by Medicare for Deception in print or online must be granted by the author in writing.