Complaint resolution service publishes case studies, recall information and consumer news.

The consumer group representing people aged 50 or older and their spouses came out swinging this week against the government’s proposed Medicare Advantage rates.

“AARP believes inflated payments to Medicare Advantage plans are unfair and fiscally irresponsible. Congress should ensure that traditional Medicare and Medicare Advantage compete on a level playing field,” said AARP Director of Government Affairs David Sloane.

Last month, the independent Medicare Payment Advisory Commission (MedPAC) found that reimbursements to Medicare Advantage plans are 12 percent more than reimbursements to Medicare’s traditional fee-for-service program. All taxpayers and all Medicare members—not just the 18 percent of Medicare members enrolled in private MA plans – are funding these inflated payments.

“Right now Medicare payments clearly favor the MA program over traditional Medicare, which is unfair to the majority of beneficiaries who participate in the traditional program. The federal government should be financially neutral with regard to Medicare reimbursement,” continued Sloane.

Medicare Advantage plans were supposed to provide the same benefits as fee-for-service more efficiently—not at greater cost to the program. In the past, they were able to provide extra benefits to beneficiaries through the greater efficiencies achieved by managed care (e.g., care coordination, negotiated prices, provider networks). Today, because of the excess payments to the plans, they have no incentive to achieve these efficiencies.

According to the nonpartisan Congressional Budget Office (CBO), the federal government could save $65 billion over five years and $160 billion over 10 years, if Medicare Advantage plans were paid at the same rates as traditional Medicare providers.

Posted under Customer Service

Brand name prescription drug prices continue to rise at about twice the rate of inflation, according to the latest AARP Watchdog Report.

AARP’s Watchdog Report found that ten of the brand name drugs it tracks increased at least four times the rate of general inflation during 2006. Ambien led the pack with a 29.7 percentage increase in manufacturer price, followed by Combivent at 18.3 percent and Atrovent Inhaler at 16.9 percent.

“The report highlights that drug prices continue to skyrocket,’ said David Sloane, Senior Managing Director, Government Relations & Advocacy. “Over time escalating drug prices will make Medicare drug plans unaffordable for older Americans. One way to address high drug prices is to take full advantage of Medicare’s bargaining power and allow Medicare to negotiate lower drug prices.”

Bob Elliott, a 75-year-old retiree from Kentucky, enrolled in a Medicare drug plan in 2006 after losing retiree prescription drug coverage from his former employer. He takes six prescriptions daily and by July 2006 reached the coverage gap, also known as the “donut hole” at which time he began paying full price for his medications. Only two of his medications are available in a generic version. “It was real sticker shock,” said Elliot. “I went from paying a co-payment to full price. My out-of pocket expenses on drugs alone in six months reached $2,000. Prescription drug prices are too high and hit older Americans’ wallets the hardest.” As brand name drug prices continue to rise more and more Americans can expect a similar fate.

“We need to send a loud and clear message to the pharmaceutical industry that Americans cannot afford to continue to pay the highest prices for prescription drugs in the world,” continued Sloane.

The Watchdog Report shows that nearly 200 of the most commonly used brand name drugs for older adults rose 6.2 percent in 2006, nearly twice the general rate of inflation, which was 3.2 percent. 2006 also marked the first year that the new Medicare drug benefit was in effect.

In contrast, manufacturer list prices in 2006 for 75 generic drugs tracked by AARP’s Watchdog Report fell by 2.0 percent. This continues a downward trend for manufacturer price increases for already lower-priced generic drugs that began in 2003.

Posted under Health

In spite of the high use of complementary and alternative medicine (CAM) among people age 50 or older,69 percent of those who use CAM do not talk to their doctors about it, according to a new survey conducted by AARP and the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health. The survey examined conversations between patients and their physicians regarding CAM use.

CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. It includes such products and practices as herbal supplements, meditation, homeopathy, and acupuncture.

“We know that people 50 and older tend to be high users of complementary and alternative medicine, but this study was the first to explore gaps in communications regarding the use of CAM between patients and their physicians,” said Cheryl Matheis, AARP Director of Health Strategies. “Communication is important to ensure the wise use of all conventional and CAM therapies.”

Differences in communication practices across demographic groups were also found. Women were more likely than men to have discussed CAM use (26 percent versus 16 percent) and what types of therapies to use (70 percent versus 51 percent). In addition, people with incomes of $75,000 or more (31 percent) or $25,000 to $49,999 (25 percent) frequently discussed CAM use with doctors.

“An open dialogue between consumers and their physicians is critical to ensuring safe and appropriate integrated care,” said Margaret A. Chesney, Ph.D., NCCAM’s Deputy Director. “As the Federal Government’s lead agency for scientific research on CAM, NCCAM is especially committed to educating both consumers and health care providers about the importance of discussing the use of CAM and providing evidence-based information to help with health care decision-making.”

This telephone survey, administered to a nationally representative group of 1,559 people age 50 or older, revealed some reasons why doctor-patient dialogue is lacking. Respondents most often did not discuss their CAM use with doctors because the physicians never asked (42 percent); they did not know that they should (30 percent); or there was not enough time during the office visit (19 percent). Interestingly, men who had seen a doctor were more likely than women not to have discussed CAM because their doctors never asked (46 percent versus 38 percent).

Other highlights from the survey report include:
Dialogue Topics

* The topics most often discussed with doctors were the effectiveness of a CAM therapy (67 percent); what to use (64 percent); how a CAM therapy might interact with other medications or treatments received (60 percent); advice on whether to pursue a CAM therapy (60 percent); and safety of a CAM therapy (57 percent).

Prescription and Over-the-Counter Medication Use

* Nearly three-fourths of respondents said they take one or more prescription medications; in addition, 59 percent of respondents said they take one or more over-the-counter medications. Twenty percent of respondents reported taking more than five prescription medications.
* The high number of prescription and over-the-counter medications used by this group underscores the need for consumers and physicians to discuss all therapies, including CAM, to ensure safe, integrated care.

View a complete copy of the survey report

Posted under Health

In a poll and related report released today, AARP found prescription drug affordability continues to challenge Americans as manufacturer prices for nearly 200 of the most commonly used brand name medications for older adults rose, on average, 6.3% in the 12 months ending with June 2006.

According to AARP’s latest quarterly Watchdog that monitors drug prices, the average manufacturer price increase for brand name drugs continues to outpace the annual 3.8% rate of general inflation for that same period. On average, manufacturers of 75 generic drugs widely used by people age 50+ increased prices by a relatively low 0.4%.

“Frustration over this issue will lead to action,” said AARP Senior Managing Director of Government Relations David Sloane, citing a new AARP election “pulse poll.” Voters ages 42 and over, the most likely to cast ballots in November, defined prescription drug affordability as a major concern. The new AARP election “pulse poll” found that this issue rises to the top of domestic issues for November.

“Although millions in Medicare are now saving with the help of their Medicare drug plans, those in the coverage gap are paying on their own and know how expensive their medications have become. In addition, nearly seven million Americans ages 50-64 have no health insurance, are paying full freight, and need relief,” explained Sloane.

Posted under Health

A new report from the AARP Public Policy Institute (PPI) states that from January of 2005 through May of 2006, 89.8 million Americans were potentially exposed to identity theft as a result of security breaches involving sensitive personal information. As security breaches at high profile institutions have made the public aware of the seriousness of this problem and more concerned about the safety of their personal information, PPI has analyzed the kinds of institutions most often experienced by security breaches and also the most common ways used to gain sensitive personal information.

The report, “Into the Breach: Security Breaches and Identity Theft,” closely examined 244 publicly disclosed security breaches that took place from January 1, 2005 through May 26, 2006. It found that educational institutions were more than twice as likely to report a breach as healthcare organizations, financial services companies, corporations, and government agencies.

The report found that 40 percent of the publicly disclosed security breach incidents were caused by hackers or insider access specifically targeting sensitive personal information. Breaches caused by hackers or insider access put the personal information of 50 million individuals (making up 56 percent of all breach victims) at risk of identity theft.

“Security breaches have become all too common in our daily lives,” said Dalmer Hoskins, AARP Managing Director of Public Policy. “And while safeguards are constantly being improved to protect personal information, it is also incumbent upon all institutions that experience a security breach to immediately alert those individuals in danger of identity theft so that they can take measures to further reduce that risk.”

While companies across the country look for ways to protect private information from outside hackers, the report shows that much of the threat comes from within the walls of the institutions themselves. The report notes that of all the ways used to improperly gain or display personal information, 30% are the result of breaches from the inside.

Posted under Privacy

AARP, the American Cancer Society Cancer Action NetworkSM (ACS CAN) and the American Diabetes Association are working together to defeat a proposal expected to be voted on in the US Senate SOON that could make health care coverage more expensive for sicker or older workers and eliminate coverage protections for important health screenings and treatments for cancer, diabetes and other life-threatening or chronic illnesses.

These leading health and consumer organizations previewed a joint national advertising effort that will help educate voters about negative effects of the Health Insurance Marketplace Modernization and Affordability Act of 2006 (S. 1955). Sponsored by Senators Mike Enzi (R-WY) and Ben Nelson (D-NE) the bill could make it harder for workers age 50 and older to get a job that provides health insurance, among other things.

In addition, health advocates worry about the long-term effects this bill will have on citizens nationwide, as it would preempt state guarantees of coverage for health benefits such as mammography, cancer screenings, emergency care, mental health services, and diabetes supplies and education.

The bill would allow any insurer to sell health policies that bypass state consumer protections requiring coverage for cancer screenings and treatments, diabetes supplies and education, well-child care and immunizations, maternity care, emergency services, and mental health care.

By doing so, Congress would partly undercut the states’ traditional role of regulating the business of insurance, such as setting requirements for what benefits should be covered and how insurance should be priced. The bill would let insurance companies sell health policies that do not meet state requirements, such as fairness in pricing for those who are older and those who are sicker.

AARP CEO Bill Novelli explains, “While it is a laudable goal to make health insurance more accessible and affordable for small businesses, the ‘Health Insurance Marketplace Modernization and Affordability Act’ does so by giving these businesses an incentive to avoid hiring or retaining sicker or older workers.”

“Ensuring access to cancer screenings and treatments is critical in the nation’s effort to reduce cancer deaths,” said John R. Seffrin, PhD, CEO for the American Cancer Society. “This bill would do more harm than good by undermining the critical work our volunteers and state legislators have done to ensure coverage for lifesaving mammograms, off-label prescription drugs and other benefits that help detect and treat cancer.”

American Diabetes Association CEO Lynn Nicholas said, “Forty-six states currently require state-regulated insurers to cover diabetes supplies, medication and treatment. S.1955, however, would allow small business health plans to bypass these vital coverage regulations. This would be devastating to millions of Americans with diabetes to whom this assurance of coverage has been a lifeline, not a luxury.”

The groups report calls pouring into lawmakers but urge consumers to continue calling. “We are a small business,” said Consumer Help Web President Joan Bounacos “but our first responsibility is to people, not an economic theory.” Bounacos’ consumer advocacy organization joined the others in calling for consumers to contact their Senators. “If you don’t know the number,” she advised, “you can always be connected directly. Just reference the Senate’s telephone directory, find your two Senators and call.”

Bounacos also urged that callers write to the American Diabetes Association at makingnoise@diabetes.org to tell them you made the call to help consumers.

Consumer Help Web acknowledges the work done by the American Diabetes Association in making us aware of this issue and providing much of the detail. All involved organizations are to be commended for their efforts in helping Americans stay healthier, not helping American financial statements grow.

Posted under Health

AARP CEO Bill Novelli issued the following statement on the Medicare prescription drug plan implementation:

Clearly, there are problems with the implementation of the new Medicare prescription drug plan. We take these problems very seriously.

The bottom line is that some people are not getting the drugs they need. This is unacceptable. If an individual has proof of eligibility, there is absolutely no reason they should pay more than required or leave a pharmacy empty-handed.

We must all do what it takes to solve the problem.

AARP is in constant contact with Medicare administrators, plan providers, pharmacies and others. Our own endorsed plan is working to resolve problems and improve customer experience. AARP is also working to inform members and the public to bring any and all enrollment documentation, government-issued Medicare card and photo identification to the pharmacy. If individuals are having trouble at one pharmacy we are recommending they try another, given that some pharmacies are handling filling prescriptions differently.

With the Medicare prescription drug program, millions of Americans now have the opportunity to access affordable prescription drugs. Providing a prescription drug benefit is the most significant change to Medicare in its 40 year history. More than one million prescriptions are being filled every day and people are realizing savings.

Posted under Health