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doctordog
09-24-2009, 06:58 PM
Editor's note: The following is the text of Senate Minority Leader Mitch McConnell's floor speech earlier this morning. The Washington Examiner has asked Sen. Max Baucus for a response, which will appear here as soon as it is received.

"Yesterday afternoon I came to the floor to speak out against one of the tactics that supporters of the President's health care proposal have resorted to in recent days.

"It appears that a particular senator has encouraged the administration to use its powers to clamp down on an opponent of the administration's health care policy.

"What's more, the administration snapped to attention at the senator's request. It followed the senator's advice, and almost immediately the government clamped down on a private health care company in my home state that had been sharing its concerns about the administration's health care proposal with seniors on Medicare.

"Yesterday, we saw how legitimate those concerns were, when the director of the non-partisan independent Congressional Budget Office said that the administration's proposed Medicare cuts would indeed lead to significant cuts in benefits to seniors. Let me repeat that.

"First and foremost, this episode should be of serious concern to millions of seniors on Medicare who deserve to know what the government has in mind for their health care. But it should also frighten anyone who cherishes their First Amendment right to free speech -- whether in Louisville, Helena, San Francisco, or anywhere else.

"And it should concern anyone who's already worried about a government takeover of health care. Why? Because it seems that in order to advance its goals, the administration and its allies are now attacking citizen groups and stifling free speech.

"Let's review: at the instigation of the Chairman of the Finance Committee, the author of the health care legislation now working its way through Congress, the Executive Branch, through the Centers for Medicare and Medicaid Services, has launched an investigation into Humana for explaining to seniors how this legislation might affect their coverage.

"One more time: a private health care provider told its elderly clients how health care legislation might affect their lives. And now the federal government is putting its full weight into investigating that company at the request of the senator who wrote the legislation in question.

"And we now find out that the concerns that this company was raising to its clients were perfectly legitimate, according to the director of the CBO.

"This is so clearly an outrage it's hard to believe anyone thought it would go unnoticed. For explaining to seniors how legislation might affect them, the federal government has now issued a gag order on that company, and any other company that communicates with clients on the issue, telling them to shut up -- or else.

"This is precisely the kind of thing Americans are worried about with the administration's health care plan. They're worried that handing government the reins over their health care will lead to just this kind of intimidation. They're worried that government agencies which were created to enforce violations even-handedly will instead be used against those who voice a different point of view.

"That's apparently what's happening here, and to many Americans, it's a preview of what's in store for everyone under the administration's health care plan.

"It's hard to imagine any justification for this. But if the people behind this latest effort believe they have some legal justification for shutting up a private company, then they need to explain themselves to the American people. More specifically, they need to explain to 11 million seniors on Medicare Advantage why they shouldn't be allowed to know how cuts to this program will affect their coverage.

"Yesterday my office called CMS to ask for the legal authority that would warrant them imposing an industry-wide gag order on an issue of public concern. We're still waiting for a response. So this morning, I'm asking the Centers for Medicare and Medicaid Services to provide my office with its justification for telling a company it can't communicate with its seniors.

"Over the past several months, we've seen a pattern of intimidation by supporters of the administration's health care proposal -- including efforts to demonize serious-minded critics at town hall meetings across the country.

"Now we're seeing something even worse: the full power of the federal government being brought to bear on businesses by the very people writing the legislation.

"This was troubling enough in itself. It's even more troubling now that we're told that Humana was exactly right in what it was telling clients. Americans were already skeptical about the administration's plan. They should be even more skeptical now."



Sen. Mitch McConnell is a Republican who represents Kentucky.

http://www.washingtonexaminer.com/opinion/columns/OpEd-Contributor/Obama-is-stifling-dissent-on-health-care-reform-8284199-60678057.html

Life_Long_Dem!
09-24-2009, 07:58 PM
are you like obbessed with the washington examiner or what? 5 out of every 6 posts that you make cite them as a link...they are just as ultra conservative as fox news...way to show unbias posting of stories ...HELL even senior numbnuts posts from more links than you do!:banghead:

Smurf-Herder
09-24-2009, 08:02 PM
are you like obbessed with the washington examiner or what? 5 out of every 6 posts that you make cite them as a link...they are just as ultra conservative as fox news...way to show unbias posting of stories ...HELL even senior numbnuts posts from more links than you do!:banghead:

So what's your argument? That none of the facts stated in the story are true, because of the source?

doctordog
09-24-2009, 08:02 PM
are you like obbessed with the washington examiner or what? 5 out of every 6 posts that you make cite them as a link...they are just as ultra conservative as fox news...way to show unbias posting of stories ...HELL even senior numbnuts posts from more links than you do!:banghead:

Unfortunately, the liberal biased papers (example-NYTIMES) and liberal biased networks-CNN, NBC, and CBS will not show or cover this story.

This is news because it shows our administration is trying to cover up, issue illegal gag orders, basically anything they can to pass this weak health bill.

It appears Humana was perfectly legal in sending those letters to seniors informed them of the truth and this government tried to silence it.

MintJulep
09-24-2009, 08:05 PM
are you like obbessed with the washington examiner or what? 5 out of every 6 posts that you make cite them as a link...they are just as ultra conservative as fox news...way to show unbias posting of stories ...HELL even senior numbnuts posts from more links than you do!:banghead:LLD, do you support a fascist "gag order" placed on insurers --private businesses by the govt-- for telling their clients the TRUTH?

Is that what you're saying?

Life_Long_Dem!
09-24-2009, 08:12 PM
LLD, do you support a fascist "gag order" placed on insurers --private businesses by the govt-- for telling their clients the TRUTH?

Is that what you're saying?
No...I just find it really funny how libs that post from certain sites alot get told that their sources are not very reliable because they have a left skant but to post from ultra conservative outlets like fox and the washington examiner is perfectly fine. And while you are on the topic of stiffling dissent..how about the last 8 years..how protesters were sqaushed...not aloud in ANY Bush townhall or any other appearance and kept at bay at a distance...remember what you guys did to the Dixie Chicks for simply expressing their opinion which they have a right to do...WHERE EVER they may happen to be...etc I could go on for hours but you get the point soooo.....DEAL WITH IT!

Smurf-Herder
09-24-2009, 08:14 PM
"Shut Up! The Government Says" - McConnell on Humana Letter

ABC’s Z. Byron Wolf reports: Democrats announced yesterday that HHS was investigating whether the insurer Humana was misleading seniors about health reform legislation. And CMS, the government entity within HHS that administers Medicare told Humana, in no uncertain terms, to cease and desist lobbying its customers on health reform legislation.

But today Republicans accused the White House and CMS of trying to implement a “gag order” on insurance companies that provide Medicare Advantage programs.

Senate Minority Leader Mitch McConnell does not normally get riled up, but he just gave an impassioned speech on the Senate floor about the gag order, Humana, and Senate Finance Committee Chairman Max Baucus, who initiated the HHS investigation. McConnell referred to Baucus only as “a colleague.”

“Using the full weight of the federal government’s enforcement powers to stifle free speech should trouble all Americans — and all of us — even more,” McConnell said. “We cannot allow government officials to target individuals or companies because they do not like what they have to say.”

“Shut up! the government says,” said McConnell on the Senate floor of the CMS letter to Humana. “Don’t communicate with your customers. Be quiet and get in line,” he said facetiously.

There are two points to remember here. Humana is based in Kentucky, so McConnell is quick to protect them. And second, he is a staunch defender of the first amendment. For instance, McConnell is the often the only Republican to vote against a flag burning amendment when it periodically arises.

In a written statement, House Minority Leader John Boehner calls a letter of rebuke from CMS Humana “outrageous” and accuses the White House of “trying to keep seniors in the dark about the consequences of congressional Democrats’ costly government-run health care bills.”

“Would the Administration impose this sort of gag order if seniors were being given information promoting the Obama health care plan? I don’t think so,” says Boehner in the statement. “Seniors have a right to know about the cost and consequences of the Democrats’ health care bills, and Republicans will continue to tell the American people the facts about the nearly $500 billion in Medicare cuts that Democrats are proposing.”

CMS told Humana in its own letter yesterday, not to lobby its customers on the issue.

“CMS is concerned that, among other things, this information is misleading and confusing to beneficiaries, represents information to beneficiaries as official communications about the Medicare Advantage program, and is potentially contrary to federal regulations and guidance for the MA and Part D programs and other federal law, including HIPAA. As we continue our research into this issue, we are instructing you to end immediately all such mailings to beneficiaries and to remove any related materials directed to Medicare enrollees from your website,” according to a letter addressed from Teresa DeCaro, a CMS employee, to executives at Humana.

In its mailer to people enrolled in Humana Medicare Advantage programs, Humana said bills being considered in Washington include cuts to Medicare, Medicaid and Medicare Advantage programs.

Saving costs by making Medicare more efficient and cutting down on fraud in Medicaid are key sources of revenue Democrats envision paying for their health reform overhaul.

Humana admits in its letter that Medicare and Medicaid need to be run more efficiently, but adds, “if the proposed funding cut levels become law, millions of seniors and disabled individuals could lose many of the important benefits and services (emphasis theirs) that make Medicare Advantage valuable.

The insurer also entreats its members to join a “partner” program to get information from Humana about health reform and to contact their Congressman about how important Medicare Advantage is. It is that last part, lobbying, that most frustrated the Democrats.

UPDATE: There has been swift and vocal pushback to this Humana flap by Democrats. It has more to do with the assertion that healthcare bills will cut Medicare benefits than it does with the gag order.

“As indefensible as it is for insurance companies to send out propaganda for the sole purpose of scaring our nation’s seniors, those who have been paying attention shouldn’t be shocked,” said Jim Manley, spokesman for Senate Majority Leader Harry Reid. “Insurers have spent millions of dollars to keep in place a system that is breaking the backs of American families with their skyrocketing costs and unfair practices. It’s clear that we are closer than ever to meaningful reform because defenders of the status quo are ginning up lies and scare tactics to stand in the way of fixing our broken system.”

And the Democratic Senatorial Campaign Committee pointed out that McConnell has taken a fair bit of campaign coin (more than $112,000 over his decades-long career).

"Mitch McConnell’s full-throated defense of one of the insurance giants seeking to kill health care reform may be unseemly, but it is certainly not surprising given all the Humana money lining his coffers,” said DSCC spokesman Eric Schultz.

Most to that point is what one Democratic staffer said.

“When my car insurer sends me a notice it is about my deductible not what congress is doing. Humana has plenty of outlets to express their view of potential legislation. They hire armies of lobbyists,” said the staffer. “Finally the information they were providing was misleading - there are ZERO changes to the benefits that Medicare participants are entitled to under the law in this bill.“

The distinction here is what constitutes a cut versus a cost saving. Health reform is financed largely by Medicare and Medicaid cost savings. The government will not cut any Medicaid benefits, but they will cut how much money they pay doctors and hospitals for services, etc, potentially affecting benefits in the future.

And Medicare Advantage plans are another separate issue. These privately administered Medicare-plus other benefits plans are an alternative to the fee-for-service that seniors on normal Medicare receive. They also cost the government about 14 percent more per person.

http://blogs.abcnews.com/thenote/2009/09/shut-up-the-government-says-mcconnell-on-humana-letter.html

MintJulep
09-24-2009, 08:16 PM
No...I just find it really funny how libs that post from certain sites alot get told that their sources are not very reliable because they have a left skant but to post from ultra conservative outlets like fox and the washington examiner is perfectly fine. And while you are on the topic of stiffling dissent..how about the last 8 years..how protesters were sqaushed...not aloud in ANY Bush townhall or any other appearance and kept at bay at a distance...remember what you guys did to the Dixie Chicks for simply expressing their opinion which they have a right to do...WHERE EVER they may happen to be...etc I could go on for hours but you get the point soooo.....DEAL WITH IT!LLD

This has been all over the news. The Obama Admin has gagged insurers for communicating the FACT that their eugenics "plan" will eliminate Medicare Advantage for Seniors. The CBO came out and confirmed that this week which directly contradicted your Dear Leader's words.

Do you support this type of action from the govt?

doctordog
09-24-2009, 08:43 PM
LLD

This has been all over the news. The Obama Admin has gagged insurers for communicating the FACT that their eugenics "plan" will eliminate Medicare Advantage for Seniors. The CBO came out and confirmed that this week which directly contradicted your Dear Leader's words.

Do you support this type of action from the govt?

He supports anything that will turn into a handout.

Moby
09-25-2009, 09:56 AM
are you like obbessed with the washington examiner or what?
He doesn't seem to understand the difference between the various types of media. If a politician that he supports says it than it must be true. If a politically active billionaire does funds it than it must be fair and balanced. If it actually mentions facts and sources of the facts than it's part of the evil liberal media.

Moby
09-25-2009, 09:57 AM
So what's your argument? That none of the facts stated in the story are true, because of the source?
Aren't you often laughing at other sources? What if he kept posting articles from the Daily KOS bloggers? Your elitism is showing Smurf.

Life_Long_Dem!
09-25-2009, 11:11 AM
LLD

This has been all over the news. The Obama Admin has gagged insurers for communicating the FACT that their eugenics "plan" will eliminate Medicare Advantage for Seniors. The CBO came out and confirmed that this week which directly contradicted your Dear Leader's words.

Do you support this type of action from the govt?
I do believe I answered that with ONE word the first time you asked......
No...I just find it really funny how libs that post from certain sites alot get told that their sources are not very reliable because they have a left skant but to post from ultra conservative outlets like fox and the washington examiner is perfectly fine. And while you are on the topic of stiffling dissent..how about the last 8 years..how protesters were sqaushed...not aloud in ANY Bush townhall or any other appearance and kept at bay at a distance...remember what you guys did to the Dixie Chicks for simply expressing their opinion which they have a right to do...WHERE EVER they may happen to be...etc I could go on for hours but you get the point soooo.....DEAL WITH IT!

Smurf-Herder
09-25-2009, 11:35 AM
Aren't you often laughing at other sources? What if he kept posting articles from the Daily KOS bloggers? Your elitism is showing Smurf.

No, I'm merely asking if the content was of any importance to him.

So I posted an article on it from another source, if he doesn't like the original.

Moby
09-25-2009, 12:08 PM
No, I'm merely asking if the content was of any importance to him.

So I posted an article on it from another source, if he doesn't like the original.
A Republican politician is bashing a Democratic politician. :disbelief: Wow!

Yes, you have shown your elitism quite often on news sources. You've even posted The Drudge and support some of Rupert's minions. You have NO right to ever question a news source while supporting so many non news sources.

MintJulep
09-25-2009, 12:15 PM
A Republican politician is bashing a Democratic politician. :disbelief: Wow!

Yes, you have shown your elitism quite often on news sources. You've even posted The Drudge and support some of Rupert's minions. You have NO right to ever question a news source while supporting so many non news sources.
No Moby, it is just a tad more than that. Please read my response to LLD. The federal govt is putting a 'gag order' on private insurers to prevent them from communicating the true impact on Medicare Advantage. I don't see how you can support such fascist measures.

doctordog
09-25-2009, 01:22 PM
He doesn't seem to understand the difference between the various types of media. If a politician that he supports says it than it must be true. If a politically active billionaire does funds it than it must be fair and balanced. If it actually mentions facts and sources of the facts than it's part of the evil liberal media.

I understand that you support fascist ideas and will try to discredit any source the is against those ideas and beliefs.

Moby
09-25-2009, 04:17 PM
I understand that you support fascist ideas and will try to discredit any source the is against those ideas and beliefs.
So show me where I've supported "Fascist" ideas.

I've asked you to support you claims many times and you never do. Now do it you lying sack of shit.

doctordog
09-25-2009, 06:52 PM
So show me where I've supported "Fascist" ideas.

I've asked you to support you claims many times and you never do. Now do it you lying sack of shit.

You are doing it now by trying to discredit the article since it wasn't published on a liberal website, even Smurf showed you another link and yet you complain. Lastly, I back up many things on here that many understand. I cannot help if your programming will not allow you to see things objectively.

MintJulep
09-26-2009, 08:41 AM
So show me where I've supported "Fascist" ideas.

.fas⋅cism 
–noun 1.(sometimes initial capital letterhttp://cache.lexico.com/dictionary/graphics/luna/thinsp.png) a governmental system led by a dictator having complete power, forcibly suppressing opposition and criticism, regimenting all industry, commerce, etc., and emphasizing an aggressive nationalism and often racism.

Moby, please read the above and tell me silencing a private insurer --via a "gag order"-- from telling their customers the truth is not an element of fascism.

Are you on board with this?

Moby
09-26-2009, 08:49 AM
You are doing it now by trying to discredit the article since it wasn't published on a liberal website, even Smurf showed you another link and yet you complain. Lastly, I back up many things on here that many understand. I cannot help if your programming will not allow you to see things objectively.
No you lying sack of shit.

I'm making fun of you and questioning your elitism. The article is a Republican politician bashing Democratic politician.

Questioning the elitism that you and Smurf show is not Fascism.

Now put up or shut the fuck up! Show me one statement where I support the suppression of information?

I've never attacked the AP for posting news about what on in Iraq.
I've never attacked the New York Times for posting news either.

If that is Fascism than aren't all the media sources that have attacked news outlets for releasing news information supporting Fascism? You know, like so many of your sources?

Moby
09-26-2009, 08:54 AM
Let's see what Humana was sending out and let's see the actual gag order.

These same media sources have flat out lies to the public on so many occasions that no one even tries to defend them as honest or legitimate any more.

Why not wait until you actually see some evidence instead of just following the same people that a history of lying to you?

Moby
09-26-2009, 08:56 AM
fas⋅cism 
–noun 1.(sometimes initial capital letterhttp://cache.lexico.com/dictionary/graphics/luna/thinsp.png) a governmental system led by a dictator having complete power, forcibly suppressing opposition and criticism, regimenting all industry, commerce, etc., and emphasizing an aggressive nationalism and often racism.
So you mean those that have attacked the New York Times or Associated Press for reporting on The Iraq War are fascists?

That's very interesting. Now please show me where I've supported the suppression of actual news. I'm sure that we can dig up many reports and claims from the far right.

MintJulep
09-26-2009, 09:15 AM
So you mean those that have attacked the New York Times or Associated Press for reporting on The Iraq War are fascists?

That's very interesting. Now please show me where I've supported the suppression of actual news. I'm sure that we can dig up many reports and claims from the far right.No. Individual criticism is not the same as the government using its powers to silence a private organization sharing information with its customers.

The govt using a gag order to silence private insurers is an element of fascism.

bairdi
09-26-2009, 10:06 AM
Let's see what Humana was sending out and let's see the actual gag order.

These same media sources have flat out lies to the public on so many occasions that no one even tries to defend them as honest or legitimate any more.

Why not wait until you actually see some evidence instead of just following the same people that a history of lying to you?
There is no such thing as the actual gag order. The term "gag order" is just one more bit of deceitful framing coined by the insurance industry to muddy the waters so that they can continue spreading their propaganda campaign. Instead of doing the legwork and researching the facts behind the story, most people, depending on their political leanings, are content to run with whatever spin agrees with their view of the world. It is a shame that we have reached a point in this country where individuals can take an event like this and twist it around in order to spread misinformation like "the government is using a gag order to silence private insurers."

Smurf-Herder
09-26-2009, 11:09 AM
A Republican politician is bashing a Democratic politician. :disbelief: Wow!

Yes, you have shown your elitism quite often on news sources. You've even posted The Drudge and support some of Rupert's minions. You have NO right to ever question a news source while supporting so many non news sources.

I've also posted from the LA Times, NY Times, CNN, MSNBC, US News & World Report, TIME Magazine, Government websites, Reuters, AP, UPI, and others, as well.

When did I ever post anything from the Drudge Report?

That's kinda hard to do, if you know what you're even talking about. All the Drudge Report is, is a page of links to stories from other sources. Maybe one story a month is actually a Drudge "breaking story" - that when the details become better known, becomes a link to another source. So virtually nothing on the Drudge Report is news written by Matt Drudge; but links to stories from various news organizations and other sources, covering the entire spectrum.

doctordog
09-26-2009, 03:36 PM
No you lying sack of shit.

I'm making fun of you and questioning your elitism. The article is a Republican politician bashing Democratic politician.

Questioning the elitism that you and Smurf show is not Fascism.

Now put up or shut the fuck up! Show me one statement where I support the suppression of information?

I've never attacked the AP for posting news about what on in Iraq.
I've never attacked the New York Times for posting news either.

If that is Fascism than aren't all the media sources that have attacked news outlets for releasing news information supporting Fascism? You know, like so many of your sources?

You are attacking this thread that clearly defines a insurance company being stopped from communicating basic facts affecting their customers. So you are supporting fascism if you side with the goverment or not. So you put up or shut your fucking pie hole.

MarkMiller
09-26-2009, 04:09 PM
Lets get to the heart of this.

What government agency said what to whom. Was it documented, where is the information about this to be found. Can we see it. Does it support the claims being made by the senator.

I need much more meat (careful) to understand the situation.

MarkMiller
09-26-2009, 04:09 PM
fas⋅cism 
–noun 1.(sometimes initial capital letterhttp://cache.lexico.com/dictionary/graphics/luna/thinsp.png) a governmental system led by a dictator having complete power, forcibly suppressing opposition and criticism, regimenting all industry, commerce, etc., and emphasizing an aggressive nationalism and often racism.

Moby, please read the above and tell me silencing a private insurer --via a "gag order"-- from telling their customers the truth is not an element of fascism.

Are you on board with this?
Link please

MarkMiller
09-26-2009, 04:13 PM
Nevermind Minty....I found it.

http://dictionary.reference.com/browse/fascism

Now....I'm gonna get so much shit for this.....but I just can't resist. LOL!

Word History: It is fitting that the name of an authoritarian political movement like Fascism, founded in 1919 by Benito Mussolini, should come from the name of a symbol of authority. The Italian name of the movement, fascismo, is derived from fascio, "bundle, (political) group," but also refers to the movement's emblem, the fasces, a bundle of rods bound around a projecting axe-head that was carried before an ancient Roman magistrate by an attendant as a symbol of authority and power. The name of Mussolini's group of revolutionaries was soon used for similar nationalistic movements in other countries that sought to gain power through violence and ruthlessness, such as National Socialism.

OK......wait for it........

MarkMiller
09-26-2009, 04:18 PM
http://img104.imageshack.us/img104/5567/congresslv1.jpg

http://clerk.house.gov/images/photos/virtual_tours/Bronzefasces.jpg

:doh:

MarkMiller
09-26-2009, 04:19 PM
Now how did Glenn Beck miss THIS! LOL!

MintJulep
09-26-2009, 04:38 PM
Lets get to the heart of this.

What government agency said what to whom. Was it documented, where is the information about this to be found. Can we see it. Does it support the claims being made by the senator.

I need much more meat (careful) to understand the situation.
The government branch called CMS, Center for Medicare and Medicaid Services sent a letter, a "gag order", prohibiting private insurers to share information with their customers.

Elmendorff of the CBO confirmed the information Humana shared with their customers, which is the cuts to Medicare would essentially eliminate Medicare Advantage for Seniors, is completely accurate.

http://www.usnews.com/blogs/peter-roff/2009/09/24/democrats-gag-the-health-insurance-industry-over-obamacare.html

MarkMiller
09-26-2009, 04:43 PM
The government branch called CMS, Center for Medicare and Medicaid Services sent a letter, a "gag order", prohibiting private insurers to share information with their customers.

Elmendorff of the CBO confirmed the information Humana shared with their customers, which is the cuts to Medicare would essentially eliminate Medicare Advantage for Seniors, is completely accurate.

http://www.usnews.com/blogs/peter-roff/2009/09/24/democrats-gag-the-health-insurance-industry-over-obamacare.html
Ahw......I thought I would get at least on spit take out of the Fascism thing.

Anyway...OK, I got the government agency now who sent the letter. But who received it exactly. What insurance company or companies and is there anywhere to see this letter and it's contents to begin to form a educated opinion.

I don't question the accuracy because I have nothing to base it on.

MintJulep
09-26-2009, 04:53 PM
Ahw......I thought I would get at least on spit take out of the Fascism thing.

Anyway...OK, I got the government agency now who sent the letter. But who received it exactly. What insurance company or companies and is there anywhere to see this letter and it's contents to begin to form a educated opinion.

I don't question the accuracy because I have nothing to base it on.Humana, but the gag order applies to all insurers. The government squelching valid information to a private business to further their own agenda is pure fascism.

bairdi
09-26-2009, 04:57 PM
Dawn Teo

Arizona Politics
Posted: September 23, 2009

Late last week, Medicare officials admonished Humana for using Medicare customer lists to engage in political advocacy and lobbying. Monday, Medicare officials sent a memorandum to all Medicare insurance companies explicitly prohibiting them from doing the same. This action by the Center for Medicare and Medicaid Services (CMS) represents a major policy shift from one administration to another and could lead to a legal case with the potential to establish new legal principles within a contested area of First Amendment (free speech) law.

Political Or Commercial Speech?

Tuesday, Senate Minority Leader Mitch McConnell (R-KY) took to the floor of the Senate to argue, "This is American -- citizens, either as individuals or grouped together in companies, have a fundamental right -- a fundamental right -- to talk about legislation they favor or oppose in this country. This is the core of the First Amendment’s protection of speech."

However, Constitutional scholars agree commercial speech is not the "core" of the First Amendment's protection. Courts consistently give political speech the greatest level of protection under the First Amendment and commercial speech the lowest protection. Courts also hold political speech to the lowest standards of accuracy and commercial speech to the highest standards of accuracy. After that, it gets complicated.

Stanford Law School Lecturer Chip Pitts notes, "The power of companies and the possibility of commercially oriented powerful communications unfairly distorting the public debate and obstructing the best (or better) policy outcomes has been the rationale underlying regulation in this area for more than a century."

For more than 100 years, explains Pitts, many have regarded concentrations of power (e.g., corporations, unions) with a high degree of suspicion, which harkens back to the question of corporate personhood. Some legal theorists and political scientists contend that powerful actors can disrupt the political process and crowd out discuss and debate in the marketplace of ideas.

Currently, the Center for Medicare and Medicaid Services (CMS) does not include political communications in its Medicare Marketing Guidelines [pdf]. This is perhaps due to the question of Constitutional limitations on the regulation of political speech: The government can regulate speech that is deemed commercial (e.g., communications in the pecuniary interest of an insurance company) but not speech that is deemed purely political in nature. Spokespersons at CMS were unable to answer this question.

Falsities or Debatable Points?

In his book, Corporate Social Reponsibility - A Legal Analysis, Pitts points to a landmark Supreme Court ruling that said, "there is no constitutional value in false statements of fact."

The question becomes, then, what is the truth? On one hand, Democrats claim health insurance reform would cut costs, not benefits, but Republicans claim that cost-saving measures in current health insurance reform proposals could result in benefit cuts. Insurance company mailers to Medicare Advantage customers are really repeating the same things members of Congress are sending to their constituents.

A number of Huffington Post readers have written in to let us know that they have been receiving letters and mailers from Republican members of Congress that say the same things that Medicare Advantage providers are sending to their Medicare customers (sometimes verbatim).

HuffPost reader Karen Coulter wrote in to say she received a three-page letter from Rep. Nathan Deal (R-GA) that says, "...seniors who are pleased with their current plan will lose their choice in selecting a plan which best fits their individual needs...."

Ed Adams of Port Saint Lucie, Florida sent us a copy of recently appointed Senator George LeMieux's (R-FL) weekly email update, which also claims that current health reform proposals would cut Medicare and Medicare Advantage.

But the Court has drawn a clear distinction between what a corporation can say and what an individual can say. An individual's right to deceptive speech is often protected while a corporation may be barred from the same deceptive speech.

To boil it down, whether or not the mailers sent by health insurance companies to Medicare customers are protected the First Amendment depends on two things: (1) whether the mailer is commercial or political, and if it is deemed commercial speech, (2) whether the mailer contains falsities or debatable points. These questions were posed to a number of experts, and the answer was always, "It depends." Experts do agree that, as a court case, this has the potential to establish significant changes in legal precedent.

Pitts, who is currently teaching a course in corporate social responsibility at Stanford, says, "Notwithstanding the law in this case, corporations especially if granted 'rights' and 'privileges' similar to those of individual citizens, have ethical duties of good citizenship that include communicating openly and truthfully, not actively interfering with regulation that’s truly in the public interest, and affirmatively trying to promote the authentic public interest of the societies of which they are part."

Protected Information or Customer Contacts?

CMS says that Humana and other insurance companies may have erred by misusing government-owned Medicare mailing lists. Under current regulations, Medicare beneficiaries' personal information, including contact information, is protected under the law and can only be used for very specific purposes: discussing current benefits/coverage. Anything outside of that scope is simply not allowed. Specifically, CMS prohibits lobbying.

The Humana mailer, like others, was sent in an envelope claiming to contain "IMPORTANT INFORMATION about your Medicare Advantage plan" and imparts urgency upon the recipients to "OPEN TODAY!"

Jonathan Blum, acting director of CMS' Center for Drug and Health Plan Choices said, "We are concerned about the recent mailings as they claim to convey legitimate Medicare program information about an individual's specific benefits or other plan information. We are concerned that, among other things, the information in the letter is misleading and confusing to beneficiaries, who may believe that it represents official communication about the Medicare Advantage program." Blum went on to say, "We are concerned that the materials Humana sent to our beneficiaries may violate Medicare rules by appearing to contain Medicare Advantage and prescription drug benefit information, which must be submitted to CMS for review"

Organizing and lobbying (astroturfing) by Medicare Advantage providers is not new. During the Bush years, Medicare Advantage companies routinely organized their customers, evening flying them to Washington, DC to lobby Congress directly. In fact, Medicare watchdogs have been asking CMS to regulate provider-to-customer political communications for years.

Others are arguing that CMS is acting in a political capacity and not treating all political communications equally. Congressman Dave Camp sent a letter to CMS pointing out that "no such pressure has been applied to those supportive of the President’s Medicare cuts." Camp points specifically to AARP who , he says, has also communicated with its Medicare customers advocating for health insurance reform but "has apparently received no such scrutiny from the Administration. CMS’ selective use of its regulatory authority, 'threatens the integrity of the agency and of our democracy.'"

UPDATE: I just received this statement from AARP in regards to the questions posed by Humana supporters asking whether AARP (who was not admonished by CMS) could also be using Medicare customer lists (like the ones used by Humana) to send political communications, "The [contact] lists used for AARP's advocacy efforts are created for that purpose from our entire membership. HIPAA regulations prohibit access to customer lists from health insurers. Therefore, we do not and could not create mailing lists based on whether a member has purchased AARP-branded health insurance."


http://www.huffingtonpost.com/dawn-teo/does-humana-have-a-free-s_b_297224.html

MarkMiller
09-26-2009, 05:00 PM
So far as I can see there is a question as to whether or not a probe (careful) of the Insurance Company Humana's marketing strategy, constitutes a gag order and if so, does that constitute suppression of Freedom of speech?


First, prove what Humana has been saying is not a falsehood. Not that easy, but not impossible.

Next, what is the law regarding a private insurance agency "Lobbying" it's members? Does Humana receive federal funding and/or government assistance of any kind?

And finally, is the Center for Medicare and Medicaid Services within their rights to issue the letter it did in the language it did to the company it did?

MarkMiller
09-26-2009, 05:16 PM
Humana, but the gag order applies to all insurers. The government squelching valid information to a private business to further their own agenda is pure fascism.
Well, first of all....don't believe everything you read on the Internet. The dictionary definition we were looking at only defined fascism from the "Party" formed and simplified it down a little too much. It misuses the term of Dictator only because of the Italian party. Fascism as an ideal actually came about as an answer to socialism, or more precisely as a counter to it.

Fascism is a tactic really more than a true political ideology. It's a form of Counter Culture in a way.


So...if you think about it.....your using fascist tactics to protest a socialist agenda. Fascism isn't about squelching valid information, it's anti-socialism and anti liberalism. Fascists advocate the creation of a single-party state.

MintJulep
09-26-2009, 05:26 PM
So far as I can see there is a question as to whether or not a probe (careful) of the Insurance Company Humana's marketing strategy, constitutes a gag order and if so, does that constitute suppression of Freedom of speech? Nothing a private company shares with their customers warrants intervention by the feds.

First, prove what Humana has been saying is not a falsehood. Not that easy, but not impossible.Oh, it's absolutely possible.

"WASHINGTON — Congress' chief budget officer on Tuesday contradicted President Barack Obama's oft-stated claim that seniors wouldn't see their Medicare benefits cut under a health care overhaul.

The head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, told senators that seniors in Medicare's managed care plans could see reduced benefits under a bill in the Finance Committee.

The bill would cut payments to the Medicare Advantage plans by more than $100 billion over 10 years.

Elmendorf said the changes "would reduce the extra benefits that would be made available to beneficiaries through Medicare Advantage plans."

http://www.google.com/hostednews/ap/article/ALeqM5gJK9ly3ovzfflxGjV-dxk2sLILKgD9ASOPSO2

Next, what is the law regarding a private insurance agency "Lobbying" it's members? Does Humana receive federal funding and/or government assistance of any kind?No. It is a private business. CMS works in tandem with insurance companies re: Medicare claims/payments with their supplemental plans.

And finally, is the Center for Medicare and Medicaid Services within their rights to issue the letter it did in the language it did to the company it did?NO. It is the govt putting the gag on private insurers for giving information which endangers their agenda.

MarkMiller
09-26-2009, 05:43 PM
Nothing a private company shares with their customers warrants intervention by the feds.

Oh, it's absolutely possible.

"WASHINGTON — Congress' chief budget officer on Tuesday contradicted President Barack Obama's oft-stated claim that seniors wouldn't see their Medicare benefits cut under a health care overhaul.

The head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, told senators that seniors in Medicare's managed care plans could see reduced benefits under a bill in the Finance Committee.

The bill would cut payments to the Medicare Advantage plans by more than $100 billion over 10 years.

Elmendorf said the changes "would reduce the extra benefits that would be made available to beneficiaries through Medicare Advantage plans."

http://www.google.com/hostednews/ap/article/ALeqM5gJK9ly3ovzfflxGjV-dxk2sLILKgD9ASOPSO2

No. It is a private business. CMS works in tandem with insurance companies re: Medicare claims/payments with their supplemental plans.

NO. It is the govt putting the gag on private insurers for giving information which endangers their agenda.
Uhm....OK....now....which plan is he talking about. They have changed to the Baucus Bill and even that is being scrutinized heavily. My thought is this, is the Insurance company in the wrong by not writing until a bill was approved before making criticisms of a bill that hadn't even been introduced? Were they giving accurate information or sending political pressure from a persons insurance carrier?

MarkMiller
09-26-2009, 06:11 PM
Nothing a private company shares with their customers warrants intervention by the feds.

That's simply incorrect;

Humana policy requires compliance with federal and state rules, laws, and regulations and Humana requirements by all contracted providers, subcontractors, vendors, and any other entity doing business with Humana serving its Medicaid membership.

http://www.humana.com/providers/tools/pdf/false_claims_florida.pdf

MintJulep
09-26-2009, 06:16 PM
That's simply incorrect;

Humana policy requires compliance with federal and state rules, laws, and regulations and Humana requirements by all contracted providers, subcontractors, vendors, and any other entity doing business with Humana serving its Medicaid membership.

http://www.humana.com/providers/tools/pdf/false_claims_florida.pdf What "law" is Humana breaking by sharing information with their customers?

I really can't believe you're supporting this.......this is unprecedented.

MarkMiller
09-26-2009, 06:20 PM
Humana Mailer Targets Elderly, Claims Medicare Benefits To Be Cut

Many elderly Las Vegas residents were alarmed and confused Wednesday after receiving a mailer with an enclosed letter signed by the Chief Medical Officer of Humana Medicare, Philip Painter, claiming that Congress and the President are considering proposals to cut "important benefits and services" of Medicare.

The letter enclosed in the mailer tries to convince Medicare recipients that their benefits could be cut if the current health insurance reform plans are enacted (bold text same as original):

Leading health reform proposals being considered in Washington, D.C., this summer include billions in Medicare Advantage funding cuts, as well as spending reductions to original Medicare and Medicaid. While these programs need to be made more efficient, if the proposed funding cut levels become law, millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable.

To ensure Humana customers read the packet, it arrives in an envelope claiming to contain "IMPORTANT INFORMATION about your Medicare Advantage plan" and imparts urgency upon the recipients to "OPEN TODAY!" But the mailer contains no information about the recipients' medicare plans. Rather, upon opening Humana's "Guidance when you need it most" envelope, recipients find a recruitment packet asking them to join Humana's Partner Program to "show Congress the importance of Medicare Advantage."

Humana's Partner Program is Humana's community corporate organizing arm. Using scare tactics (convincing Grandma that her Medicare benefits could be cut), an enclosed Humana Partner Program flyer asks Medicare recipients to sign up (and to sign up their friends and family) to:

receive policy propaganda Congressional updates
view member profiles of other Partner members
learn how to use your voice for Humana profits reform
receive quarterly disinformation newsletters
learn about local tea bagger parties Humana Partner opportunities


As an added bonus, Humana Partner also gives members "fun brain teasers, quizzes, and puzzles." (They probably include crossword puzzles with answers like "death panels" and "socialism")

An enclosed card says, "We want you to be informed," then asserts,

Some in Washington want to cut billions of dollars out of the Medicare Advantage program. If that happens, patients could lose many of the important benefits and services that make Medicare Advantage so valuable: Low premiums, Low deductibles and co-pays, Wellness and enhanced preventive benefits, Coordinated care and disease assistance programs.
The enclosed letter asks recipients to call their Congressional representatives, contending,

Congress is considering significant cuts to Medicare Advantage now, and your Members of Congress will want to know why this program is valuable to you because these cuts could mean higher costs and benefit reductions to many on Medicare Advantage.
Alyce from Las Vegas says she was furious after hearing from her distraught 90-year-old, wheel-chair-bound mother who, along with many of her fellow residents, received the mailer Wednesday. Alyce asks, "How do we counter these deceptive mass mailings to the elderly? They are organizing the elderly using a public relations firm to spread the lies." She says she was particularly troubled because Humana mailed this to her mother despite the fact that her mother has been diagnosed with Alzheimer's Disease.

The enclosed letter includes this disclaimer at the bottom, "Neither the Centers for Medicare and Medicaid Services nor the Medicare has reviewed these materials for accuracy or misrepresentation." (Now that's irony.)

The mailer also directs recipients to visit the Humana Partner Program website, which features an update on the front page in bold text, "Congressional Update: Medicare Advantage funding cuts proposed...again," along with the following text (bolding is original):

Now, to pay for health care reform, some in Washington have again proposed deep cuts to the Medicare Advantage program. This time, the proposed cuts could be as high as $177 billion from the Medicare Advantage program if people like you who appreciate the Medicare Advantage value don’t stand up and have your voice heard. This means seniors and disabled individuals in the Medicare Advantage program, like you, may be asked to pay for nearly a third of the initial projected cost of health care reform through higher Medicare Advantage premiums and copays and lower benefits and choices.
Obama has repeatedly said that Medicare benefits will not be cut, and that Medicare funds will not be used to pay for health insurance reform. Last week, he told Minnesotans at a health care rally, "Not a dollar of the Medicare trust fund will be used to pay for this plan -- not one dollar. We will not be lowering benefits for senior citizens."

Other sources have confirmed the President's statement. The American Association for Retired Persons (AARP) recently told the Washington Post that currently proposed cuts to Medicare would not affect benefits. AARP also told the Wall Street Journal that these types of statements are "misleading and alarmist," and "the proposed Medicare savings do not limit benefits."

At the end of 2008, about 12.5 percent of Medicare Advantage subscribers were Humana clients, and Humana receives a just over half its revenue from Medicare Advantage.

The actual letter from Human reads;

HUMANA®
Guidance when you need it most

Dear Lily:
With the media reporting daily on Congress' and President Obama's efforts to enact meaningful health reforms this year, many Humana Medicare Advantage (MA) members are contacting us with questions. Members just like you want to know what these reforms might mean for their Medicare health plan and how they can get involved to help protect Medicare Advantage.

We are working diligently to ensure that our nation's leaders understand how proposed reforms might affect you. At the same;time, we have created the Partner program to keep you informed about proposed Medicare changes and help you get involved so your voice is heard in Washington. Your opinions matter to us, to others on Medicare, and to your elected officials. There are two things you can do now to help show Congress the importance of Medicare Advantage:
• Opt into the Partner program. Becoming a Partner is easy. Just complete the accompanying, postage-paid
form and follow the instructions to fold and mail it back. As a Humana Partner, you will join more than 50,000
Humana Medicare Advantage members who are receiving information about this issue and learning how to get
involved to protect your Medicare health plan coverage.
• Let your Members of Congress know why Medicare Advantage is important to you. Congress is
considering significant cuts to Medicare Advantage now, and your Members of Congress will want to know why
this program is valuable to you because these cuts could mean higher costs and benefit reductions to many on
Medicare Advantage.
We've made it easy for you to have your voice heard. Just call (877) 698-9228 (toll-free) or visit
www.humanapartners.com for additional infonnation about this issue and how you can offer helpful input to
your elected officials.
Leading health reform proposals being considered in Washington, D.C., this summer include billions in Medicare
Advantage funding cuts, as well as spending reductions to original Medicare and Medicaid. While these programs
need to be made more efficient, if the proposed funding cut levels become law, millions of seniors and disabled
individuals could lose many of the important benefits and services that make Medicare Advantage health plans so
valuable. ~ ~ ~ __~ _
On behalf of Humana's 28,000 employees, I would like to thank you/or being a Humana membel~ We look
forward to partnering with you to ensure the Medicare Advantage program remains strong, so you can have peace of
mind about your health coverage-now and in the future!
Regards,
Philip Painter, M.D.
Chief Medical Officer
Humana Medicare
Medicare-approved HMO, PPO, and PFFSplans. Neither the Centers for Medicare and Medicaid Services nor the Medicare
hasreviewed these materials for accuracy or misrepresentation. You are not required to provide any information to us, and
information that you choose to share will not affect your membership in any Humana health plan .•
Humana Partner Program 500 W. Main St., 6th Floor Louisville, KY 40202


http://www.huffingtonpost.com/dawn-teo/humana-mailer-targets-eld_b_289421.html

MintJulep
09-26-2009, 06:20 PM
Uhm....OK....now....which plan is he talking about. They have changed to the Baucus Bill and even that is being scrutinized heavily. My thought is this, is the Insurance company in the wrong by not writing until a bill was approved before making criticisms of a bill that hadn't even been introduced? Were they giving accurate information or sending political pressure from a persons insurance carrier?Mark, the insurer sent information that was basically a heads-up that, under the new plan being proposed, their benefits (Medicare Advantage) are subject to change.

This CBO confirmed this is true. This fascist admin would like these people to remain in the dark therefore they are exerting their federal powers to silence anything that shines the light on the end result of the little tin God's agenda.

Do you not understand how this overreaching by the govt is inherently wrong??

MarkMiller
09-26-2009, 06:23 PM
What "law" is Humana breaking by sharing information with their customers?

I really can't believe you're supporting this.......this is unprecedented.
I can't support or fight against anything untill I am informed as to exactly what the problem is. It appears to be a partisan fight, but that doesn't mean either party is wrong untill it's looked into. That is what I intend to do. Look into this.

You have my attention, I am not against your point of view as long as a resonable attempt is being made to check facts, undertsand what both sides have done and see where the laws is being broken on either side. If no one is breaking any laws than it's just a political fight and means very little.

MarkMiller
09-26-2009, 06:25 PM
Mark, the insurer sent information that was basically a heads-up that, under the new plan being proposed, their benefits (Medicare Advantage) are subject to change.

This CBO confirmed this is true. This fascist admin would like these people to remain in the dark therefore they are exerting their federal powers to silence anything that shines the light on the end result of the little tin God's agenda.

Do you not understand how this overreaching by the govt is inherently wrong??
I'm not so sure that "True" is even close to what can be said here, but i am still researching. I don't know that it's an overreach, or that it's wrong. But i am open to the possiblity and you know I mean that.

MarkMiller
09-26-2009, 06:29 PM
Sorry but you lost my support with this from Humana (Edit: as reported by the Huffington Post article ).

Humana Partner Program flyer asks Medicare recipients to sign up (and to sign up their friends and family) to:

receive policy propaganda Congressional updates
view member profiles of other Partner members
learn how to use your voice for Humana profits reform
receive quarterly disinformation newsletters
learn about local tea bagger parties Humana Partner opportunities

MarkMiller
09-26-2009, 06:32 PM
The Letter Humana sent states this:

"Neither the Centers for Medicare and Medicaid Services nor the Medicare
hasreviewed these materials for accuracy or misrepresentation."

Well.....they have now.

MarkMiller
09-26-2009, 06:36 PM
If you can find the letter sent to Humana...let me know. They are not publishing it from what I can see.....but I am still looking.

Binky
09-26-2009, 06:56 PM
No...I just find it really funny how libs that post from certain sites alot get told that their sources are not very reliable because they have a left skant but to post from ultra conservative outlets like fox and the washington examiner is perfectly fine. And while you are on the topic of stiffling dissent..how about the last 8 years..how protesters were sqaushed...not aloud in ANY Bush townhall or any other appearance and kept at bay at a distance...remember what you guys did to the Dixie Chicks for simply expressing their opinion which they have a right to do...WHERE EVER they may happen to be...etc I could go on for hours but you get the point soooo.....DEAL WITH IT!


What I find interesting is the fact that you seem to waste time keeping track of where each lib is posting from and how many times they do. You are more worried about that than the fact that the gov't is trying to keep certain things from coming out in the open. What the hell is the matter with this picture?

MarkMiller
09-26-2009, 07:09 PM
What I find interesting is the fact that you seem to waste time keeping track of where each lib is posting from and how many times they do. You are more worried about that than the fact that the gov't is trying to keep certain things from coming out in the open. What the hell is the matter with this picture?

I'm not at all convinced that is what this situation is really about. In looking into this, I see that there was a letter from Humana that admits it has not been submitted to CMMS for misinformation or inaccuracies. CMMS catches what they see as inaccuracies and informs the Insurance Agencies that represent a Government Program that they may be guilty of Lobbying their members with false information against Federal and or maybe state regulations. The Insurance industry is regulated isn't it?

MarkMiller
09-26-2009, 07:34 PM
Bahahahahahahahahahahahahahaha!!!!!!!!!!!!!!

The letter sent by Humana lists the "Partnerprgram" website url address;
http://www.humanapartners.com/maintainance.aspx

which now says;

This Website is currently unavailable. We apologize for any inconvenience.

Uh huh....this is where we begin to see through this mess.....

Now who's trying to keep certain things from coming out in the open.

bairdi
09-26-2009, 07:40 PM
I'm not at all convinced that is what this situation is really about. In looking into this, I see that there was a letter from Humana that admits it has not been submitted to CMMS for misinformation or inaccuracies. CMMS catches what they see as inaccuracies and informs the Insurance Agencies that represent a Government Program that they may be guilty of Lobbying their members with false information against Federal and or maybe state regulations. The Insurance industry is regulated isn't it?
That's an excellent observation Mark. :thumbsup:

MintJulep
09-26-2009, 07:44 PM
Bahahahahahahahahahahahahahaha!!!!!!!!!!!!!!

The letter sent by Humana lists the "Partnerprgram" website url address;
http://www.humanapartners.com/maintainance.aspx

which now says;

This Website is currently unavailable. We apologize for any inconvenience.

Uh huh....this is where we begin to see through this mess.....

Now who's trying to keep certain things from coming out in the open.Nothing justifies the federal government silencing a private insurer from sharing information with their members.

I'm sorry but you are promoting fascism.

MintJulep
09-26-2009, 07:50 PM
I'm not at all convinced that is what this situation is really about. In looking into this, I see that there was a letter from Humana that admits it has not been submitted to CMMS for misinformation or inaccuracies. CMMS catches what they see as inaccuracies and informs the Insurance Agencies that represent a Government Program that they may be guilty of Lobbying their members with false information against Federal and or maybe state regulations. The Insurance industry is regulated isn't it?I'm very familiar with CMS, it is an arm of the government which administers Medicare and Medicaid. Until now, it has never been empowered to dictate to private insurers what type of information is sent to paying members.

I don't need to research this. I already have and that is why I'm sure I'm right. This is way over the line and unprecedented.

bairdi
09-26-2009, 08:11 PM
I'm very familiar with CMS, it is an arm of the government which administers Medicare and Medicaid. Until now, it has never been empowered to dictate to private insurers what type of information is sent to paying members.

I don't need to research this. I already have and that is why I'm sure I'm right. This is way over the line and unprecedented.
I believe that you are wrong. Here is a letter from the Humana website. They are certainly aware of the fact that CMS has the right to scrutinize these mailings and they agreed to it.



This letter is intended to inform providers of a new option, not to endorse
Humana
Dear Provider:
The continuing mission of the Centers for Medicare & Medicaid Services (CMS) is to improve access to health care for the [44] million Medicare beneficiaries nationwide. We have worked with various organizations that have expressed an intent to contract with CMS as Medicare Advantage (MA) Organizations, and to offer MA plans to Medicare beneficiaries. Historically, all MA plans offered to beneficiaries were “managed care” products, under which beneficiaries who enrolled were limited, at least to some extent, to a specified network of providers.
On December 26, 2002, Humana received authorization from CMS to offer an MA “private fee-for-service” (PFFS) plan, under which a beneficiary who enrolls is free to seek services from any provider who is willing to accept the plan’s terms & conditions of payment and treat the enrollee. Because this type of MA plan is new to many providers, the following information is furnished concerning some of the special features of a MA PFFS plan.
----Snip--------

Other important aspects of PFFS plans include:
• If a provider decides to accept the PFFS plan, they must follow the PFFS plan terms and conditions of payment. Provider agreement to the plan’s terms and conditions of payment is inherent in their decision to treat a PFFS plan enrollee. If a provider decides to treat a PFFS plan enrollee, then the provider must bill the PFFS plan for covered services. The provider has the right to decide, on a patient-by-patient and visit-by-visit basis, whether to treat PFFS plan enrollees. If a provider decides not to accept the PFFS plan terms and conditions of payment, then the provider should not provide services to the PFFS plan enrollees, except in an emergency.
• CMS audits the MAO to ensure that it pays providers the appropriate amount for services furnished to plan enrollees and that it pays clean claims within 30 days.
• An authorized MAO that offers a PFFS plan is subject to the same financial solvency requirement as any other MAO approved by CMS.
• Payments made by an MAO that offers a PFFS plan cannot place providers at risk by using such reimbursement methods as capitation or withholds; and correspondingly, cannot base payment on the organization’s performance using bonuses or incentives.
• All advertising, marketing collateral and marketing practice must be filed with CMS prior to their use.
• An organization that wants to offer a PFFS plan is required to seek and receive acknowledgement and approval from every State Department of Insurance prior to offering a PFFS plan. [note this does not apply to certain employer only PFFS plans which have used the Employer Policy and Operations Group state licensing waiver.]

http://www.humana.com/providers/plans/medicare/pdf/CMS%20letter.pdf

MarkMiller
09-26-2009, 08:11 PM
I'm very familiar with CMS, it is an arm of the government which administers Medicare and Medicaid. Until now, it has never been empowered to dictate to private insurers what type of information is sent to paying members.

I don't need to research this. I already have and that is why I'm sure I'm right. This is way over the line and unprecedented.
I love your enthusiasm and your "Don't quit" attitude....but just being unprecedented (which I am very unsure of) doesn't make this wrong in any way.

The wrong may actually have been Humana. We shall see.

(Edit: Reason I can't spell worth crap!)

MarkMiller
09-26-2009, 08:27 PM
Nothing justifies the federal government silencing a private insurer from sharing information with their members.

I'm sorry but you are promoting fascism.
Well I'm Italian so....:banghead:

MintJulep
09-26-2009, 09:31 PM
Well I'm Italian so....:banghead::lmao2: :lmao2:

MarkMiller
09-26-2009, 10:38 PM
:lmao2: :lmao2:
Her are some interesting facts about Benito Mussolini.

Mussolini was one of the founders of Italian Fascism. This brand included elements of nationalism, corporatism, national syndicalism, expansionism, social progress and anti-communism in combination with censorship of subversives and state propaganda. He was Head of Government, Duce of Fascism, and Founder of the Empire as well as the leader of the Italian Social Republic.

Mussolini was deposed at the Grand Council of Fascism, prompted by the Allied invasion. Soon after his incarceration began, Mussolini was rescued from prison in the Gran Sasso raid by German special forces.

He envisioned his empire as the resurrection of Ancient Rome. He died as a Roman Emperor....murdered by partisans who displayed his body to be viewed by the public.

While in control, Mussolini began a number of archaeological (sort of) projects aimed at placing Fascism in Romes future by glorifying her past. He saw himself as a new Augustus and went as so far as to completely strip the Ancient Roman Emperor's tomb of all post Roman construction down to the imperial structure and had it completely renovated as a symbol of his power. This project as well as recovering the original roadway to the coliseum striped away tones of earth and thousands of housing units.

During this time the archeology of Rome suffered considerably as no records were kept and workmanship very badly done.