Health Care

Objecting to 'Gag Order' on Insurers, Republicans Threaten to Delay HHS Confirmations

By David S. Hilzenrath

Senate Republicans said they will delay confirmation of Obama administration nominees to the Department of Health and Human Services unless HHS lifts what Republicans are calling a "gag order" on insurers.

Insurers serving people on Medicare "should not be threatened with punishment if they speak out on a matter of public concern simply because the administration disagrees with their position," Senate Republican leader Mitch McConnell of Kentucky and other top Senate Republicans said in a letter Thursday to HHS Secretary Kathleen Sebelius.

The dispute began when the big insurer Humana, which manages health plans for Medicare beneficiaries, sent a letter to health plan members saying that reform proposals under consideration by Congress could cause "millions of seniors and disabled individuals" to lose "important benefits and services." Humana urged its plan members to contact their elected representatives.

HHS accused Humana and other insurers of misleading Medicare beneficiaries. It ordered them to stop and said they could face enforcement action for violating restrictions on communications between Medicare health plans and their members.

The contretemps is the latest in a series of side-issues to engulf the debate over health care policy.

An HHS spokesman reiterated the department's position Thursday night.



"Our Department is committed to protecting Medicare beneficiaries and ensuring that their personal information is not used inappropriately. Seniors on Medicare should not be subjected to misleading information about their Medicare benefits," spokesman Nicholas Papas said in a statement. "We have serious concerns that certain communications from a major insurance company violated CMS regulations and our investigation will continue."

Several top department positions remain unfilled and could be affected by the Republicans' threat to use parliamentary procedures to delay confirmation votes. Those positions include the assistant secretary for public affairs, the surgeon general, and the administrator of the Centers for Medicare and Medicaid Services.

The communications in dispute involve so-called Medicare Advantage plans paid by the government to provide care for Medicare beneficiaries who choose to enroll in them as an alternative to traditional fee-for-service Medicare. The private plans can impose tighter restrictions on members' care while offering extra benefits.

Democratic health care legislation would reduce funding for Medicare Advantage plans, which the administration and others say are overpaid. Insurers say the funding cuts would lead to reduced benefits.

Republicans said HHS's actions were at odds with guidance it issued in 1997 on communications between Medicare HMOs and their members. "While it may be difficult for a reviewer to ascertain whether or not the information about legislation ... is accurate and without slant or unrevealed self-interest, we believe that prohibiting such information would violate basic freedom of speech and other constitutional rights of the Medicare beneficiary as a citizen," Bruce Merlin Fried, director of HHS's Center for Health Plans and Providers, wrote in 1997.

The 12-year-old memo predates changes in the regulation of Medicare health plans, "and we are in the process of evaluating those changes in this context," HHS spokesman Papas said.

The department is not aware of any insurers other than Humana spreading misleading information to their Medicare beneficiaries, Papas said.

Posted at 8:05 PM ET on Sep 24, 2009 | Category: Health Care

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