FTC WARNS ABOUT HEALTH INSURANCE SCAM

 

The Federal Trade Commission is advising people to hang up on telephone calls that threaten a fine for not having health insurance. The calls direct the recipient to someone who claims to be enforcing the health insurance law and attempts to glean the consumer's full name, birth date, Social Security number and income.  People who work in the Marketplace don’t make cold calls, and they never ask for personal information. If you get a call like this, hang up.

The phone numbers showed up with a local area code. The recorded message sounded urgent: “You need to buy health insurance or face a fine. To learn more, press 1.” A person who works in the Health Insurance Marketplace got the call and knew it was fishy, so she pressed 1. The operator claimed to ‘work with the law,’ and asked for the person’s full name, date of birth, phone number, income information and Social Security number. The person who got the call knew it was nonsense, so she hung up and contacted the FTC.

If you get a recorded sales call, but you didn’t give the caller written permission to call you, the call is illegal. Don’t press 1 to speak to the operator or get your name taken off the list, and don’t give any personal information. If you respond, you’ll probably get more calls.

If you want information about health insurance in your state, visit HealthCare.gov. or contact us here at Affincon.com.  If you get a call like this, please report it to the FTC.

 

DRUG COMPANIES HIKE PRICES

After Martin Shkreli raised the price of anti-parasitic drug Daraprim more than 50-fold to $750 a pill last year, he said he wasn’t alone in taking big price hikes.

As it turns out, the former drug executive was right. A survey of about 3,000 brand-name prescription drugs found that prices more than doubled for 60 and at least quadrupled for 20 since December 2014.

Among the biggest increases was Alcortin A, a combination steroid and antibiotic gel to treat eczema and skin infections: The price soared 1,860 percent, or almost 20-fold, during the period. And a vial of Aloprim, a Mylan NV drug for cancer complications, more than doubled, according to the survey by DRX, a provider of price-comparison software to health plans.

Skyrocketing prices are getting increased scrutiny ahead of a U.S. congressional hearing this week: Democratic Representative Elijah Cummings, ranking member on a committee that is probing drug pricing, said Tuesday that pricing “tactics are not limited to a few ‘bad apples,’ but are prominent throughout the industry.”

Even after soaring prices became an issue in the U.S. presidential campaign, the cost of many drugs has continued to rise at annual rates of more than 10 percent.  Drug makers raised the prices of products as wide-ranging as erectile dysfunction drug Viagra, heart treatments, dermatology medicine and even brands that long have lost their patents. While specialty companies have had the steepest hikes, giants such as Pfizer Inc. and GlaxoSmithKline Plc kept pushing through smaller rises.

“The data shows that price increases are an integral part of the business plan,” said Jim Yocum, executive vice president at DRX.

Pharmaceutical companies often boost prices around the end and the start of the year, and the scale of recent increases was higher than what Yocum has seen in the past few years. About 400 formulations of brand-name drugs went up at least 9.9 percent since early December, according to DRX.

 

Click here to read article: Bloomberg (02/02/16)

CIGNA BANNED FROM MEDICARE SALES

CIGNA BANNED FROM MEDICARE SALES

Cigna Corp. was banned from marketing its Medicare products to new customers, after the U.S. found deficiencies in how the health insurer ran its plans, citing widespread violations that the government said threatened patients’ health.

 “Cigna has experienced widespread and systemic failures impacting Cigna enrollees’ ability to access medical services and prescription medications,” the U.S. said in a Jan. 21 letter to the insurer outlining the sanctions. “Cigna has had a longstanding history of non-compliance with CMS requirements.”

The Centers for Medicare and Medicaid Services, or CMS, suspended Cigna from marketing and selling Medicare Advantage and Part D plans to new clients, the insurer said Friday in a regulatory filing.

Cigna and other insurers offer a privately run alternative to traditional Medicare, which includes insurance coverage for hospital and doctor care, known as Medicare Advantage, as well as prescription drug coverage, or Part D. The agency found problems involving Cigna’s appeals and grievances process, as well as with its drug coverage.

Because of those deficiencies, the government said it “determined that Cigna’s conduct poses a serious threat to the health and safety of Medicare beneficiaries.” Cigna clients who are affected by the issues cited by CMS can drop their Cigna coverage and buy policies from other insurers.

 “Cigna is working to resolve these matters as quickly as possible and is cooperating fully with CMS on its review,” the health insurer said in the filing, adding that the sanctions don’t affect benefits offered to current enrollees. Matt Asensio, a company spokesman, had no immediate comment.

NO SOCIAL SECURITY COST OF LIVING INCREASE FOR 2016

Low inflation in the US means people receiving Social Security payments won't be given a cost-of-living increase for 2016, the government said. Advocates said the news is of particular concern because of rising Medicare premiums and reduced buying power for health care. Also affected are federal retirees, disabled veterans and people getting help under the federal disability program for people with low incomes. The decision affects more than 70 million Americans.

MEDICARE PART B - 52% INCREASE JANUARY 1

$159.30 is the new normal for those ageing in to Medicare.
Medicare Part B prices impact everyone on Medicare, regardless, of whether they have a Medicare Supplement or Medicare Advantage, and Part B prices are going UP! Since there is a 'hold harmless' law, current members cannot be given an rate increase since there is NO Cost of Living increase for Social Security coming. That means the 52% increase in Part B will be felt by those who don't have their Part B taken from SS ( a weird loophole), those who will be aging into as of Jan.1, and those with higher incomes that didn't pay the standard $104.90.

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APP TELLS USERS WHAT THEIR DRUG COPAY WILL BE

 

With the current rise in prescription drug costs, several companies have popped up in recent years that promise to find consumers the lowest prices. The firms compare brand-name drugs with generic options and reveal the prices featured at local pharmacies.

Some commercial insurers offer their own price-comparison tools. OneRx, a mobile app launched nationally last week by New York health care analytics company Truveris, seeks to set itself apart by allowing a co-pay search based on the individual's insurer.

The app allows patients to enter their insurance information and find out what their co-pay will be for a prescription. To use OneRX, a picture is taken of the insurance card, and the information is available in a day. The information also can be entered manually.

At times, the app may reveal that a drug is more affordable without insurance because of step therapy requirements or other issues, said Bryan Birch, Truveris' chairman, president and chief executive.

The app takes into account manufacturer coupons, pharmacy discounts and other deals, independent of insurance coverage. Like competitor GoodRx, which also shows drug prices from different pharmacies, OneRx automates the process of searching for coupons so consumers don't have to ferret out savings on their own.

Ideally, patients will use the app while they're still in the doctors' office, which will boost their compliance with prescriptions, Mr. Birch said.