CQ's Carey Discusses New CMS Medicare Advantage Marketing Guidelines, Mental Health Parity Legislation, Package Of Health Related Bills

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Mental Health;  Public Health
Article Date: 23 Sep 2008 - 12:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

Mary Agnes Carey, associate editor of CQ HealthBeat, discusses stricter marketing guidelines for Medicare Advantage plans, chances for passage of mental health parity legislation, and a House panel's approval of a measure that would prohibit insurers from limiting hospital stays to less than 48 hours for patients who have had a mastectomy or lumpectomy in this week's "Health on the Hill from kaisernetwork.org and CQ."

Carey says that the new MA plan marketing regulations announced by CMS are intended to help prevent marketing abuses that some plans have used to pressure beneficiaries. For example, two of the regulations would ban unsolicited sales contacts and another would prohibit financial incentives that encourage insurance agents to push beneficiaries into plans with higher sales commissions. Acting CMS Administrator Kerry Weems said that to enforce the rules, the agency will increase its secret-shopper activities, review advertisements for MA plans and monitor plans' efforts to detect inappropriate sales activities.

Carey also says that Senate leaders announced a tax package that includes funding for mental health parity legislation. According to Carey, it is "unclear" whether the Senate will pass the bill because of some concerns about policy or the cost of the measure. Meanwhile, in the House, Democratic leaders intend to move the mental health parity bill as stand-alone legislation with the cost of the measure offset by "less controversial tax provisions than those in the Senate package," Carey says. The House is expected to approve its measure, but then it will have to be reconciled with the Senate bill.

Lastly, Carey discusses a package of health care bills approved by the House Energy and Commerce Committee dealing with breast cancer and health insurance. The bills would prohibit insurance companies from limiting hospital stays to less than 48 hours for patients who have had a mastectomy or breast-conserving surgery and less than 24 hours for patients who have had lymph node dissection for the treatment of cancer. Another measure approved by the panel would prohibit insurers from discontinuing coverage if a plan member unintentionally failed to disclose information on an insurance application about an unrelated condition (Carey, CQ HealthBeat, 9/19).

The complete audio version of "Health on the Hill," transcript and resources for further research are available online at kaisernetwork.org.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.