Interesting anaylsis from Martin Feldstein at the Washington Post. Here is the story.
Generally speaking, unless there is an incentive for a relatively healthy person to purchase Health Insurance (or disincentive to be uninsured), there will be significant “selection of risk” issues with the Private Insurance companies which would result in higher premium rates (potentially, creating a downward-spiral effect).
Thoughts?
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Next step in the process is to see what happens in the Senate. The Stupak Amendment, which does not allow Federal Funds to be used to pay for abortions, also passed prior to the Final Vote on HR 3962. The Stupak Amendment seemed to satisfy enough Blue Dogs to allow for passage. There was one Republican vote in favor and there were 39 Democrat votes against.
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Here is the Press Release from AARP.
Some question whether or not AARP’s licensing fees from Medigap insurance had any influence over it’s decision to endorse the bill. AARP has approximately 29% of the Medigap Market in terms of # of insureds. More here.
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The debate began at 2pm today. You can watch it live on C-Span. The fact that the Democratic Leaders brought this up for debate indicates that they have the votes to pass it. The debate is scheduled to last for 4 hours.
You can also follow the conversation on Twitter!
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Agents in the Senior Market, MUST PAY ATTENTION TO THIS!! PLEASE PASS THIS ALONG to your fellow agents IMMEDIATELY!! We must get the word out to all Insurance Agents in the Senior Market about this subject. This could affect Medicare Supplement, Medicare Advantage and Medicare Part D marketing and enrollment. Obviously, this could be expanded to more insurance coverages in the future.
CMS is proposing a Demonstration Project which could limit or eliminate the ability of the Medicare Advantage company to conduct Marketing and Enrollment in areas which are classified as “Medicare Enrollment Assistance Demonstration Site(s)”. This could limit or, possibly, eliminate the role of the independent agent in these markets. This could also limit the company’s ability to MARKET THEIR OWN PRODUCTS in these Demonstration sites.
I realize this is a bit complicated, but it is EXTREMELY IMPORTANT TO FOLLOW THIS!!
This Demonstration project would be limited to a couple of states in 2011 (probably 1-2 states) with a Third Party Contractor. This would most likely take the form of a Call Center with Representatives trained to provide one-on-one assistance to beneficiaries to help them understand their coverage options and ENROLL in plans. They would also conduct outreach via direct mail and telephone. The products they would enroll Medicare Beneficiaries in would include: Original Medicare, Medicare Advantage, Medicare Part D Prescription Drug Coverage, Medicare Supplemental Insurance Coverage (Medigap) and Employer coverage. They would also conduct outreach via: Direct Mail, Community and Educational Activities, Sub-Contracting with Community-based organizations, Community-based enrollment centers and processing enrollment applications and submitting enrollment requests to plans.
The Demonstration project would (potentially) mirror the current system of MediCAID enrollment where states use contractors to facilitate this enrollment (no agent involvement).
CMS is also contemplating placing RESTRICTIONS on MARKETING and ENROLLMENT activities in areas which are classified as “Medicare Enrollment Assistance Demonstration site(s)”. Essentially, CMS is posing an open question on what (if any) role the Medicare Advantage company would have in Marketing and Enrolling Medicare Beneficiaries in it’s own products in these demonstration areas. Would the Third Party Contractor be the SOLE source for enrollment and marketing in “Medicare Enrollment Assistance Demonstration Site(s)”??? That’s an open question at this time.
On October 28th, CMS conducted an Open Door Forum to discuss the Demonstation project. HERE IS A LINK TO THE ANNOUNCEMENT.
The Audio Recording of this Conference Call is supposed to be available on MONDAY, NOVEMBER 9th, 2009 and will be available for 30 DAYS! Here is a link on where to get it. I have not heard the Conference Call, but I intend to listen to the call on Monday and download the transcript to learn more about this.
CMS has also established a website for this Demonstration Project. Click here to Access the Medicare Enrollment Demonstration Website. You can also subscribe to get email updates from CMS on this Demonstration Project by clicking here. (I suggest you get the updates!)
PLEASE PASS THIS ALONG TO YOUR FELLOW AGENTS. WE MUST STAY EDUCATED ABOUT WHAT IS GOING ON HERE.
I just wanted to get the initial information out there. In the future, I’m looking to put together some sort of internet based group to keep everyone informed on what’s going on! Check back to the blog for updates.
Craig
Posted in CMS, MA Enrollment Demo | 6 Comments »
Thanks to Kenneth for this link. This is a good overview of what H.R. 3962 would do, as respects insurance agents.
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Here is the article from the WSJ.com. The rules will cut payments to doctors who use disease screening equipment (like MRI’s and CT Scans) by 38%.
Also, here is another article from Bloomberg on the cuts to Physicians and Specialists. The cuts will be effective in 60 days unless this is changed Legislatively by Congress and signed by the President. A 21% cut was required by the Deficit Reduction Act’s Medicare Sustainability Model, but lawmakers are looking to levelize the cuts over 4 years. A bill which would have “fixed” the Physician’s fee schedule was proposed by the House, but failed in a procedural vote.
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www.MedicareChoices.org is the website for the Coalition for Medicare Choices which is a project of AHIP. Here are a few of the ads they are running on Medicare Advantage:
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The Detroit Free Press had two nice articles in it’s Sunday paper which also appeared in their blog.
The first is a Q and A with Jennifer Houghton of the Area Agency on Aging (1-B in Michigan). Jennifer discusses the changes in Michigan with less and less Medicare Beneficiaries having access to Retiree Group Insurance and the changes in the Medicare Advantage and Part D plans for 2010. Here is the article (it’s 3 pages long).
The second article includes some links to databases with information on plans available in Michigan. Here is a link to that article.
Posted in 2010 MA Plans, Michigan, Part D | Leave a Comment »
Aetna had a relationship with Sarasota Memorial Hospital on the Commercial side, but this agreement expands the long-term contract to include Aetna’s Medicare Advantage members. The Agreement will take effect on November 1st, 2009.
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