Medicare Watch

Report: Why Consumers Disenroll from Medicare Private Health Plans

In a new report released this week, the Medicare Rights Center presented findings on why consumers disenroll from Medicare private health plans. The report examines data from calls placed in 2009 to the Medicare Rights hotline, and explores the issues that prompted consumers to disenroll. It found that the most common reasons for disenrollment are: problems accessing providers, misinformation and marketing abuse, and coverage denials for medical services.

The report recommends that the Centers for Medicare & Medicaid Services (CMS):

• strengthen oversight of plans’ marketing practices, and better educate consumers about network and coverage restrictions, given the high incidence of problems stemming from marketing abuse and provider access
• resume collecting and publishing a national disenrollment survey that would contain plan-specific data on consumers’ reasons for disenrolling.

Read the full report, Medicare Facts and Faces: Why Consumers Disenroll from Medicare Private Health Plans, and the press release.

Congress Must Act to Prevent Cuts to Medicare Physician Payments

At press time, the Senate is considering an amendment offered by Senator Max Baucus, Democrat of Montana, which is a scaled-back version of the Tax Extenders Bill that failed to pass the Senate yesterday. Passage of the Tax Extenders Bill is necessary to reverse a 21 percent cut in Medicare physician payments that took effect June 1.

Some policymakers who voted against the bill, did so in part because some provisions, including those that would prevent a cut in Medicare physician payments (known as the “doc fix”), were not paid for. In order to gain the votes necessary to move forward on legislation to stop the cuts, the amendment under consideration includes a paid-for “doc fix” that would prevent the reduction in payments to Medicare physicians for six months—through November 30—instead of 19 months as included in the original bill. It also provides a 2.2 percent increase in Medicare physician payment rates through November 30.

The amendment also includes a six-month extension of the enhanced Federal Medical Assistance Percentages (FMAP), which increase the federal share of funding for state Medicaid programs. This provision would help state governments that are currently struggling under serious financial constraints and would help prevent cuts to state programs.

Read a statement by Medicare Rights President Joe Baker.

There is still time to take action. After the Senate votes, the House of Representatives will vote on legislation passed by the Senate. Contact your members of Congress.

Medicare Reminder

If your Medicare private health plan refuses to pay for a service that you have been prescribed—a test or surgery, for example—you have the right to appeal.

Learn more about how to file an appeal on Medicare Interactive, the Medicare Rights Center’s free online counseling tool.

Spotlight

A recent investigation conducted by Inside Edition exposed abusive marketing practices of insurance agents that sell, among other things, Medicare-related products such as Medigap policies that supplement Original Medicare. Watch the full story to learn more about deceptive marketing practices.