US CMS probes Humana Rx drug plan advice

The US Centers for Medicare and Medicaid Services (CMS) is investigating allegations that health insurance giant Humana "inappropriately" advised the highest-cost beneficiaries in its Medicare Part D prescription drug plans to switch to plans offered by rival Sierra Health Services.

The Congressional newspaper The Hill reports that Sierra made the claims in a conference call to investment analysts in late February. Anthony Marlon, Sierra's chief executive, told The Hill that an "extraordinary amount of drugs" were being prescribed to some beneficiaries the newly-launched SierraRx Plus drug plan, which provides comprehensive coverage for both branded and generic drugs through the coverage gap (the "Donut hole;" Marketletters passim). Mr Marlon said that the plan will not be available from next year.

Humana's director of Media and Public Relations, Dick Brown, said that the CMS had approved Humana's sales representatives' script, which mentioned Sierra's plan to some of Humana's existing customers.