Insurer's 'wa$te' products
By JAMES FANELLI
The New York Post
It's enough to make you sick.
A federally subsidized health insurer is wasting tax dollars, hawking overpriced medical supplies to its members that could be bought at a fraction of the cost online or in stores.
Private insurer Evercare doles out about $50 worth of "benefit credits" every three months to its plan members and sends them a catalog from which to pick the items. The items include everything from a first-aid kit to over-the-counter painkillers to exercise equipment.
One example of the unhealthy spending is a Nexcare Reusable ColdHot Pack. Evercare lists the price at $20 in its catalog, but the same item can be bought online from medical-supply distributor JRS Medical for $12.27.
"It's a rip-off," said a Murray Hill retiree and Evercare plan member. "I could walk into Jack's 99 Cent Store on 40th Street and get these things cheaper . . . It's the reason why the government is losing money."
Evercare is a Medicare Advantage plan, a privately run insurance fund that receives hefty subsidies from Medicare. About 11 million Medicare recipients are enrolled in MA plans, and the federal government spent $109.7 billion on those plans in 2009. MA plans took off in the 1990s, when private insurers convinced the feds that they could provide cheaper coverage than Medicare and offer more benefits and perks with minimum premiums or none at all.
The plans initially saved the government about 5 percent on the average cost of a regular Medicare recipient. But now, the federal government spends 14 percent more on MA plans than regular Medicare. That equals about $849.90 in monthly subsidies per MA plan member, according to the Kaiser foundation, which focuses on health-care issues.
The federal health-care overhaul signed in March aims to make the costs of MA plans even with regular Medicare.
Matthew Burns, a spokesman for Evercare, said, "Our catalog pricing is competitive with most retail pharmacies and, unlike most online outlets, our pricing includes shipping charges."
jfanelli@nypost.com
Read more: http://www.nypost.com/p/news/local/insurer_wa_te_products_8LAMZjidS8ac1PA0GkAp0N#ixzz0rPW527OB
Showing posts with label advantage plan. Show all posts
Showing posts with label advantage plan. Show all posts
Sunday, June 20, 2010
Sunday, June 6, 2010
STARK, CONGRESSIONAL LEADERS URGE HHS SECRETARY TO PROTECT SENIORS IN MEDICARE ADVANTAGE PLANS
(From PoliticalNews.me)
Washington, DC – House Ways and Means Health Subcommittee Chairman Pete Stark (D-CA), along with House Ways and Means Committee Chairman Sander Levin (D-MI), Senate Finance Committee Chairman Max Baucus (D-MT), House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.), Senate Finance Health Subcommittee Chairman Jay Rockefeller (D-WV), and House Energy and Commerce Subcommittee on Health Chairman Frank Pallone, Jr. (D-N.J.), yesterday wrote Health and Human Services (HHS) Secretary Kathleen Sebelius urging her to closely review Medicare Advantage plan bids for 2011.
The congressional leaders encouraged the Secretary to require private insurance companies to justify any proposed changes in premiums or benefits for seniors in Medicare Advantage plans. The leaders also asked the Secretary to use the authority given to her by the recently passed health reform law, the Patient Protection and Affordable Care Act, to protect seniors from unwarranted rate hikes and high out-of-pocket costs.
“Insurers have been reaping huge profits at the expense of Medicare beneficiaries and taxpayers,” said Stark. “Health reform trimmed gross overpayments from the Medicare Advantage program. CMS must carefully police these insurers to make sure they don't continue bilking seniors to pad their profit margins.”
“Health reform takes critical steps toward ensuring the integrity of Medicare by arming CMS with the tools they need to protect beneficiaries from abusive insurance company practices,” said Levin. “CMS must now use these tools and remain vigilant so that Medicare beneficiaries have someone fighting in their corner.”
“Health care reform strengthened Medicare and made Medicare Advantage more competitive, but it is critical that we don’t let private insurance companies use these changes as an excuse to raise premiums or cut benefits for seniors to bolster their own bottom line,” said Baucus. “The Affordable Care Act gave the Secretary new authority to crack down on private insurance companies that take advantage of the Medicare Advantage program and I’m confident she will use it protect seniors’ benefits.”
“Seniors on fixed incomes shouldn’t be subjected to exorbitant health care premium increases,” said Rockefeller. “The Federal Government must continue to crack down on the unscrupulous practices of private health insurers.”
“Medicare plays a critically important role insuring that millions of Americans receive the health care they need,” said Waxman. “Today we are encouraging the Administration to take a critical look at the Medicare Advantage plans’ bids for 2011 to insure that taxpayer funds are spent wisely.”
“Thanks to the Affordable Health Care Act, the Secretary of Health and Human Services will have the power she needs to properly monitor Medicare Advantage plans during the bidding process,” said Pallone. “I urge her to use her new authority to carefully review the bids being submitted by Medicare Advantage plans to make sure that they are in the best interest of America’s seniors.”
Stark, Baucus, Levin, Waxman, and Pallone all worked to draft and pass the Affordable Care Act in March of this year.
Washington, DC – House Ways and Means Health Subcommittee Chairman Pete Stark (D-CA), along with House Ways and Means Committee Chairman Sander Levin (D-MI), Senate Finance Committee Chairman Max Baucus (D-MT), House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.), Senate Finance Health Subcommittee Chairman Jay Rockefeller (D-WV), and House Energy and Commerce Subcommittee on Health Chairman Frank Pallone, Jr. (D-N.J.), yesterday wrote Health and Human Services (HHS) Secretary Kathleen Sebelius urging her to closely review Medicare Advantage plan bids for 2011.
The congressional leaders encouraged the Secretary to require private insurance companies to justify any proposed changes in premiums or benefits for seniors in Medicare Advantage plans. The leaders also asked the Secretary to use the authority given to her by the recently passed health reform law, the Patient Protection and Affordable Care Act, to protect seniors from unwarranted rate hikes and high out-of-pocket costs.
“Insurers have been reaping huge profits at the expense of Medicare beneficiaries and taxpayers,” said Stark. “Health reform trimmed gross overpayments from the Medicare Advantage program. CMS must carefully police these insurers to make sure they don't continue bilking seniors to pad their profit margins.”
“Health reform takes critical steps toward ensuring the integrity of Medicare by arming CMS with the tools they need to protect beneficiaries from abusive insurance company practices,” said Levin. “CMS must now use these tools and remain vigilant so that Medicare beneficiaries have someone fighting in their corner.”
“Health care reform strengthened Medicare and made Medicare Advantage more competitive, but it is critical that we don’t let private insurance companies use these changes as an excuse to raise premiums or cut benefits for seniors to bolster their own bottom line,” said Baucus. “The Affordable Care Act gave the Secretary new authority to crack down on private insurance companies that take advantage of the Medicare Advantage program and I’m confident she will use it protect seniors’ benefits.”
“Seniors on fixed incomes shouldn’t be subjected to exorbitant health care premium increases,” said Rockefeller. “The Federal Government must continue to crack down on the unscrupulous practices of private health insurers.”
“Medicare plays a critically important role insuring that millions of Americans receive the health care they need,” said Waxman. “Today we are encouraging the Administration to take a critical look at the Medicare Advantage plans’ bids for 2011 to insure that taxpayer funds are spent wisely.”
“Thanks to the Affordable Health Care Act, the Secretary of Health and Human Services will have the power she needs to properly monitor Medicare Advantage plans during the bidding process,” said Pallone. “I urge her to use her new authority to carefully review the bids being submitted by Medicare Advantage plans to make sure that they are in the best interest of America’s seniors.”
Stark, Baucus, Levin, Waxman, and Pallone all worked to draft and pass the Affordable Care Act in March of this year.
Thursday, April 29, 2010
Most Medicare Advantage Enrollees Aren’t in Best Plans
By Katherine Hobson
From the Article in Wall Street Journal
A study finds that fewer than a quarter of Medicare Advantage participants are enrolled in plans rated very good or excellent by Medicare’s own rating system, the Associated Press reports.
The Avalere Health study, to be released today, finds that about 47% of participants are covered by plans receiving three or two stars, out of a possible five, under the government’s rating system. Only 23% are in four- or five-star plans, the AP says. And according to the consulting firm, 14% aren’t rated because they’re too new or lack the data required to score them.
Those scores will soon be used to do more than guide consumers; starting in 2012, better-scoring plans – four stars and up – will get higher payments from the government than lower-scoring ones. As Avalere President Dan Mendelson tells the AP, “When you start linking quality to payment, you can bet the plans are going to be very motivated to bring the scores up.”
An insurance industry spokesman tells the AP that it will be difficult for some plans to improve their ratings given the criteria – which include telephone customer service, success in managing chronic conditions and how many plan participants complain or quit.
From the Article in Wall Street Journal
A study finds that fewer than a quarter of Medicare Advantage participants are enrolled in plans rated very good or excellent by Medicare’s own rating system, the Associated Press reports.
The Avalere Health study, to be released today, finds that about 47% of participants are covered by plans receiving three or two stars, out of a possible five, under the government’s rating system. Only 23% are in four- or five-star plans, the AP says. And according to the consulting firm, 14% aren’t rated because they’re too new or lack the data required to score them.
Those scores will soon be used to do more than guide consumers; starting in 2012, better-scoring plans – four stars and up – will get higher payments from the government than lower-scoring ones. As Avalere President Dan Mendelson tells the AP, “When you start linking quality to payment, you can bet the plans are going to be very motivated to bring the scores up.”
An insurance industry spokesman tells the AP that it will be difficult for some plans to improve their ratings given the criteria – which include telephone customer service, success in managing chronic conditions and how many plan participants complain or quit.
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