Saturday, June 01, 2013

Continuing to Ask CMS (Centers for Medicare & Medicaid Services) to Investigate Humana mental health $500/ year deductible for Previously In-Network Providers

Here is the (obvious) reason why Humana is creating barriers to mental health care as associated with the $500 deductible/ year for previously In-Network Medicare providers: 

Report Shows Better Outlook for Medicare

"....The Medicare trustees — four federal officials and two public representatives — said in their annual report that the “modest improvement” in the outlook for Medicare’s long-term finances reflected lower projected spending for skilled nursing homes and private Medicare Advantage plans."

Yes, your tax payer money has been paying private enterprise, such as Humana, and the other Medicare 'Advantage' companies to stay in business.  Your tax $$ have been lining the pockets of private CEO's and their employees.  And now, in order to keep making money-----since the jig is up re: continuing to keep them afloat with their 15+% administrative oversight fees----versus Medicare's 5% administrative oversight fees----they will do whatever it takes to create barriers to care.  

Here is the letter I wrote today following up on my complaint about Humana pretending to be a Medicare Advantage company.  

"Dear CMS Investigator (telephone number: 410 786 1047: Tilghman, Cornell C. (CMS/CMM) ): 

I have not heard a word re: my complaint associated with ALL of my Humana clients being required to have a $500 deductible for mental health services as Humana as of January 1, 2013 required me to be 'in network' though in years past----as they are purportedly a "Medicare Advantage" company----there was no issue.  As you know, Medicare requires a $200 deductible for ALL medical and mental health services at the beginning of every year.  

Therefore, why does Humana require----ONLY FOR MENTAL HEALTH CARE BEST I KNOW-----a $500 deductible before I am paid below the rate for Medicare? 

Yes, I have turned in all my paperwork to become an In Network Humana provider but Humana never advised me that this was necessary.  I had to discover the matter when my claims were not paid.  

I have a complaint; I want a solution and an answer.  And I want to be paid for my work that has been done as I was never advised by Humana about this change.  And neither were my clients-----unless they perhaps had bothered to read every single piece of fine print sent to them by Humana.  I am informed that Humana sends out several letters a week to clients.  They simply cannot keep up w/ this deluge of information whose obvious intention is to disallow them from discovering changes that Humana has made. 

I am awaiting the response from CMS (Centers for Medicare and Medicaid Services) please and was assured a month ago that I would have a response by now.  

Thank you.  

Marsha V. Hammond, PhD"


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