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."

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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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