Senior Issues (B) Task Force
Senior Issues (B) Task Force Page
Joint Executive (EX) / Plenary Committee Summary Report
Winter 2009 Meeting Summaries Index

The Senior Issues (B) Task Force met Dec. 6, 2009. During this meeting, the Task Force:

• Received an update on pending federal action regarding Medicare supplement insurance, Medicare private plans and long-term care that are being considered as part of health reform legislation. 

• Received an update on long-term care insurance issues. In October, Mary Beth Senkewicz (FL) testified on behalf of the NAIC before a joint hearing of the Senate Special Committee on Aging and the Senate Committee on Homeland Security and Government Affairs—Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia. The focus of the hearing was a pending 25% premium increase for participants in the federal employee long-term care insurance program. There is also a newly created Long-Term Care (EX) Task Force, which met for the first time Dec. 6. 

• Discussed the status of revisions to the Long-Term Care Insurance Model Regulation (#641) that clarify claims denial reporting (Appendix E). These revisions were adopted by the Health Insurance and Managed Care (B) Committee Nov. 9 and will be considered by the Joint Executive (EX) Committee/Plenary Dec. 7. 

• Received an update on the Long-Term Care Partnership program. There are now partnership policies available for sale in 31 states. State plan amendments have been approved in five additional states. There are approximately 131,000 Partnership policies. There are now 100 insureds with Partnership policies in claim. 

• Discussed implementation of revisions to the Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act (#651), as required by the federal Genetic Information Nondiscrimination Act (GINA) and the Medicare Improvements for Patients and Providers Act (MIPPA). Sept. 24 was the deadline set by MIPPA for states to adopt the model revisions. Forty-eight jurisdictions (including Puerto Rico and the District of Columbia) have adopted the revisions. Three states are waived from the federal requirement. One remaining state is moving quickly toward final adoption, pending approval from the state legislature. 

• Reviewed draft technical corrections to the Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act (#651) to address errors in the text and outline of coverage charts, including typos, formatting and punctuation errors, and missing words and numbers. A draft has been distributed to states with a request for feedback, and it is posted on the Task Force Web site. Comments will be incorporated, and the model will be updated in January. The Task Force discussed one specific correction in Section 9.1E(8)(c) of the model dealing with Medicare Part A lifetime reserve days.

• Received a report from the Accident and Health Working Group of the Life and Health Actuarial Task Force on Medicare supplement and long-term care insurance issues. 

• Received a report from the NAIC-CMS (Centers for Medicare and Medicaid Services) policy group, which held a conference call Nov. 18 and discussed the following issues of mutual interest: 1) changes to CMS’ contract with MEDIC (the Medicare Drug Integrity Contractor) so that one section will now focus solely on compliance and enforcement issues, such as agent/broker investigations and marketing abuses; 2) CMS’ agent/broker training and testing program; 3) agent/broker compensation structures for Medicare Advantage plans; 4) CMS’ efforts to reduce the number of low-enrollment and duplicative Medicare private plans; and 5) communication regarding nonrenewals of Medicare Advantage Private Fee-For-Service plans that will occur in late 2010 as a result of new network requirements. It is anticipated that this group will continue to hold regular conference calls and may meet in person again in 2010. 

• Received a report from a CMS representative on Medicare supplement issues, including a verbal overview of a pending response letter from the CMS Administrator regarding Medicare supplement hospital network arrangements. This letter reportedly states that CMS believes there is no federal authority to block such arrangements, but states continue to have the authority to disapprove them. Task Force members expressed concern about CMS’ response and will consider developing additional guidance for state regulators. The CMS representative also raised an issue regarding coverage of Durable Medical Equipment (DME) for Medicare supplement plans that include a benefit for Medicare Part B Excess Charges. The Task Force has taken under advisement CMS’ view that carriers are responsible for DME charges beyond the usual 15%, and may consider whether the addition of “usual and customary” language may be necessary. 

• Received a report from a CMS representative on Medicare private plan issues. Nonrenewal notices will be sent to 412,000 beneficiaries this month for Medicare Advantage and Medicare prescription drug plans who are not renewing their contracts for 2010. CMS is also continuing secret shopping of sales events and has provided training to state departments of insurance representatives. The Task Force will work with CMS to develop ideas for MEDIC, now that one section will be dedicated to compliance and enforcement investigations and audits relating to issues such as agent/broker violations and marketing abuses. 

• Received a report from Wisconsin on their recent expansion of Medicare supplement guarantee issue provisions for individuals whose employer-sponsored coverage is substantially reduced and for individuals enrolled in a Medicare Select plan whose hospital leaves their network, leaving them with no other network hospital in a 30-minute or 30-mile radius.