Wednesday, February 28, 2018

MACs given new directions on 2-midnight rule settlement agreements

The Centers for Medicare and Medicaid Services (CMS) recently announced partial settlement agreements and instructions for Medicare Administrative Contractors (MACs) in relation to several 2-midnight rule cases. Under the 2-midnight rule, Medicare beneficiaries should be admitted to the hospital as inpatients only if they are likely to spend two nights – or cross two midnights – in the hospital. However, there is a concern that some physicians may be reluctant to admit Medicare beneficiaries, particularly on the basis of potential complications. If a physician believes the patient may experience problems after an ordinarily non-overnight procedure, the physician may place the patient in observation status. Changing to observation status is preferred over risking payment denial by admitting a patient who does not end up spending two midnights in the hospital.

On November 9, 2017 CMS issued a Transmittal outlining how MACs can ensure hospitals receive payments related to the 0.2% downward payment adjustment in the inpatient prospective payment system (IPPS). The settlement agreement stemmed from the American Hospital Association’s (AHA) 2015 challenges to CMS’s 0.2% IPPS payment adjustment. The AHA and other hospital organizations filed suit arguing that CMS lacked authority to impose the payment cut. CMS insisted the cut was necessary due to anticipated increases in inpatient hospital expenses associated with the 2-midnight rule implementation. The agreement reflected in the Transmittal will result in the application of an interest adjustment factor for determining payment between June 1, 2017 and May 31, 2018 for discharges at facilities.


Wellness programs aren't generating Medicare savings

By Virgil Dickson  | February 26, 2018

Seniors in wellness programs targeting obesity, falling and chronic conditions are not sparking healthcare spending decreases, according to a federal analysis released Friday.

The Affordable Care Act required the CMS conduct an independent evaluation of wellness programs that targeted various health conditions experienced by Medicare beneficiaries, and that study found no evidence of cost savings.

"Utilization and expenditures actually increased among (chronic-care management) program participants," the report said.

The findings are based on spending data for Medicare enrollees in fall prevention, weight loss and chronic care initiatives. The CMS followed beneficiaries one year after they joined a wellness program.

The results mirror those found in the corporate world, where companies are increasingly funding wellness programs meant to improve employees' health.

Corporate wellness spending hit $8 billion in 2016, up from $1 billion in 2011, according to researchers The Harris School of Public Policy at the University of Chicago.

Researchers have also found that these efforts have aided in employee retention, but not changes in employee behavior or cuts in healthcare spending.

Although the wellness programs didn't save money, the CMS found that Medicare enrollees in wellness programs were more aware of their mental health needs and had increased engagement with physicians and ancillary services.

"So, while it didn't reduce healthcare expense or utilization, it seems to have had a positive impact," said Steve Wojcik, vice president of public policy at National Business Group of Health. These programs "prevented or delayed normal deterioration that comes with age."

Wellness initatives also take time to become successful, according to Cheryl Larson, president and CEO at Midwest Business Group on Health.

Wellness programs "may or may not result in short-term outcomes, but if it helps identify one case of cancer or diabetes in at-risk populations, they can achieve positive outcomes down the road," Larson said.

Virgil Dickson reports from Washington on the federal regulatory agencies. His experience before joining Modern Healthcare in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul University in 2007.

http://www.modernhealthcare.com/article/20180226/NEWS/180229934?utm_source=modernhealthcare&utm_medium=email&utm_content=20180226-NEWS-180229934&utm_campaign=am

20 states sue federal government to abolish Obamacare

By Erica Teichert  | February 26, 2018

Twenty states sued the federal government on Monday to end the Affordable Care Act, claiming the repeal of the individual mandate's tax penalty rendered the law unconstitutional.

The U.S. Supreme Court upheld the ACA in 2012, determining President Barack Obama's healthcare reform law was a tax penalty. But the tax cuts signed by President Donald Trump in December zeroed out the penalty, and the rest of the ACA can't stand as law without it, according to the states.

"Once the heart of the ACA—the individual mandate—is declared unconstitutional, the remainder of the ACA must also fall," the states wrote in the complaint, filed in federal court in Fort Worth, Texas.

The case from a group of Republican-governed states is led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, who slammed the law as an "unconstitutional and irrational regime" forced on the states that undermined their sovereignty.

Health insurance is regulated by the states, but the ACA required states to create or adopt exchanges where individuals could purchase plans. The law also imposed certain requirements on plans, including covering pre-existing conditions.

Since Trump signed the tax cut law, some states have taken action to stabilize their individual markets. In January, Wisconsin Republican Gov. Scott Walker urged the state Legislature to pass a reinsurance program that would help minimize rate increases for residents. Idaho GOP Governor Butch Otter has issued an executive order that would allow insurers to sell plans that don't comply with the ACA, as long as they also have compliant plans for sale in the state.

The attorneys general also noted that insurers have left the individual markets in several states citing the ACA, leaving many with only one plan available for health coverage.

The complaint also alleged states were harmed because residents could meet the individual mandate by signing up for Medicaid or the Children's Health Insurance Program, and many eligible individuals may not have requested coverage without the ACA.

"What remains then is the individual mandate, without any accompanying exercise of Congress' taxing power, which the Supreme Court already held that Congress has no authority to enact," according to the complaint. "Not only is the individual mandate now unlawful, but this core provision is not severable from the rest of the ACA—as four justices of the Supreme Court already concluded."

Erica Teichert assigns, edits and directs news coverage for Modern Healthcare’s website and magazine. She previously served as the publication’s New York bureau chief and legal reporter. Before joining Modern Healthcare in 2016, she worked at Law360 as legal newswire’s first D.C. bureau chief after three years as a court reporter covering the U.S. Supreme Court, D.C. Circuit and other federal courts and agencies. Prior to that, she worked as an associate editor for FierceMarkets. She has a bachelor's degree in communications with a print journalism emphasis from Brigham Young University.

http://www.modernhealthcare.com/article/20180226/NEWS/180229931?utm_source=modernhealthcare&utm_medium=email&utm_content=20180226-NEWS-180229931&utm_campaign=am

Feds drop bulk of second UnitedHealth Medicare Advantage suit

By Erica Teichert  | February 27, 2018

The U.S. Justice Department on Monday ditched most of its lawsuit over UnitedHealth Group's Medicare Advantage billing practices.

In a brief notice to a federal district court in Los Angeles, the Justice Department said it wouldn't update its lawsuit to revive claims over the accuracy of UnitedHealth's Medicare Advantage billing data. Instead, the federal government will only litigate whether the data used to secure more than $1 billion in Medicare Advantage payments was invalid.

U.S. District Judge Michael Fitzgerald pared down the suit earlier in February, determining that any statements UnitedHealth made about the data's accuracy wouldn't have affected whether the government paid the Medicare Advantage claims.

UnitedHealth's vice president of communications Matt Burns said the company will "continue to contest aggressively the remaining claims."

Medicare Advantage plans are paid a flat per-beneficiary fee from the CMS for covering individuals. The agency adjusts payments to take into account sicker members by using risk scores. There have been several whistle-blower lawsuits in recent years alleging health plans inflate members' risk scores to secure higher payments.

UnitedHealth, Aetna, Health Net, Humana and Cigna's Bravo Health are all under federal scrutiny for potential upcoding issues.

The federal government has seen both of its False Claims Act suits over UnitedHealth's Medicare Advantage billing fall flat in the last several months. In October, the Justice Department dropped a similar lawsuit alleging UnitedHealth and its affiliated plans exaggerated how sick its patients were to score millions of dollars in inflated Medicare Advantage payments.

Erica Teichert assigns, edits and directs news coverage for Modern Healthcare’s website and magazine. She previously served as the publication’s New York bureau chief and legal reporter. Before joining Modern Healthcare in 2016, she worked at Law360 as legal newswire’s first D.C. bureau chief after three years as a court reporter covering the U.S. Supreme Court, D.C. Circuit and other federal courts and agencies. Prior to that, she worked as an associate editor for FierceMarkets. She has a bachelor's degree in communications with a print journalism emphasis from Brigham Young University.



Medicare Expired Legislative Provisions Extended and Other Bipartisan Budget Act of 2018 Provisions

On February 9, 2018, President Trump signed into law the Bipartisan Budget Act of 2018. This new law includes several provisions related to Medicare payment.
With regard to payment for outpatient therapy services, the law repeals application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier as a confirmation that services are medically necessary as justified by appropriate documentation in the medical record; and retains the targeted medical review process, but at a lower threshold amount. It also extends several recently expired Medicare legislative provisions affecting health care providers and beneficiaries, including the Medicare physician fee schedule work geographic adjustment floor, add-on payments for ambulance services and home health rural services, changes to the payment adjustment for low volume hospitals, and the Medicare dependent hospital program.
In addition, with regard to Section 53111 – Medicare Payment Update for Skilled Nursing Facilities, the Centers for Medicare & Medicaid Services has received questions from stakeholders about the impact of the FY 2019 Skilled Nursing Facility (SNF) update due to section 53111 of the BBA of 2018. To help answer these questions, we are providing information about the estimated market basket update for FY 2019 based on currently available data. This estimate may be updated in the Notice of Proposed Rulemaking for the FY 2019 SNF Prospective Payment System (PPS).

Read the full summary.

SHOP Support

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SHOP Support

Have questions about SHOP insurance? For answers and information to help you, take advantage of the following:
There are a variety of SHOP tools, calculators, fact sheets, how-to guides, videos, and other resources on HealthCare.gov to help you find the right coverage for your business.
SHOP-registered agents and brokers can help you apply for and enroll in SHOP coverage. It won’t cost you more to use an agent or broker. If you decide to work with an agent or broker, they must complete the SHOP registration requirements so you can authorize them to act on your behalf. If you already have an agent or broker, you can continue to work with them as long as they have completed the SHOP registration requirements.
SHOP Call Center Representatives are available to answer questions about SHOP. Contact the SHOP Call Center at 1-800-706-7893, Monday through Friday from 9 a.m. to 7 p.m. Eastern Time. TTY users can call 711 to reach a Call Center Representative.

With the new enrollment process for 2018 SHOP plans, insurance companies selling SHOP plans will be able to help you with questions about applications, enrollment, renewal, changing or updating coverage, and payments.

Thank you,

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Geriatrics still failing to attract new doctors

By Maria Castellucci  | February 27, 2018

The geriatrics specialty was unable to attract enough future doctors to its fellowship programs this year even as more students graduate medical school and the demand for geriatricians grows with the aging population.

The most recent data from the National Resident Matching Program show that of the 139 geriatric fellowship programs for the 2018 appointment year, just 35 were filled. Furthermore, the fellowships offered 387 positions for residents yet only 176 were filled.

The matching program figures highlight a constant problem in the field of geriatrics: It struggles to attract doctors even as the pool of medical school graduates grows as quickly as the demand for the specialty. This year, 8,753 matches were made out of a pool of 10,778 applicants, the largest in the history of the specialty match program.

"Geriatrics has struggled for a while in the context of it not being a not particularly competitive specialty," said Mona Signer, president and CEO of the National Resident Matching Program.

Indeed, the match data show that even as the specialty has increased the number of fellowship programs in recent years, it's still hard to fill them. In 2014, there were 109 geriatric fellowship programs, but the specialty was only able to fill 28 of those programs.

Many factors are at play for geriatrics' low recruitment numbers but chief among them is that the specialty pays comparatively less than other specialties, said Dr. Gregg Warshaw, adjunct professor of geriatric medicine at University of North Carolina School of Medicine who has studied recruitment of geriatricians.

The median annual salary for geriatricians is $189,879, according to Salary.com. That's less than half of what an average orthopedic surgeon or cardiologist earns. And according to the data from the National Resident Matching Program, those specialties attracted many more students to 2018 fellowship programs.

For example, cardiovascular disease filled 198 of 203 fellowship programs for 2018. Additionally, the specialty had 1,261 applicants to choose from.

Warshaw said geriatricians earn less because Medicare is their primary payer and offers historically lower reimbursement rates than commercial insurance. The pressure to pay off debt from medical school usually motivates new doctors to go into higher-paying specialties, he said. "Finances is clearly a critical issue."

Geriatricians also treat a complex patient population. Older adults typically have more comorbid conditions and they require routine follow-up care. "Their care is really around the clock, these aren't just needs you can walk away from. They are complicated patients so for a lot of younger physicians it seems like an overwhelming responsibility," Warshaw said.

The need for geriatricians is only expected to grow. There are currently 44 million Medicare beneficiaries and enrollment is expected to rise to 79 million by 2030. The American Geriatrics Society expects about 30% of those individuals will require care from a geriatrician. There are roughly 7,300 certified geriatricians currently practicing in the U.S. and the American Geriatrics Society expects 30,000 geriatricians will be needed by 2030.

Geriatricians are also being sought out by patients "more and more as a choice" particularly if they struggle with complicated issues like memory loss or frequent falls that a primary care doctor isn't trained to address, Warshaw said.

There have been several efforts to attract more students to the specialty. Medical school curricula now includes training on geriatrics so future doctors are exposed to the specialty early on in their career. Medical students who haven't been matched are recruited into the specialty, Warshaw said. The training is still valuable and can be applicable to many different concentrations.

Additionally, some states have set up debt relief programs for doctors who agree to treat older patients in communities with the greatest need.

Another bright spot is that geriatrics stands to gain from the push to value-based care, Warshaw said. Much of a geriatrician's time is spent on ways to keep frail, medically complex Medicare patients out of the hospital and healthy. That correlates with the push to outcomes-based reimbursement. "If value-based payment happens more nationally at a larger scale, that would probably increase interest in geriatrics," he said.

This data doesn't include the number of medical school graduates that were matched into residency training programs. The National Resident Matching Program will release those figures next month, Signer said.

Maria Castellucci covers safety and quality topics for Modern Healthcare’s website and print edition. Castellucci is a graduate of Columbia College Chicago and started working at Modern Healthcare in September 2015.

http://www.modernhealthcare.com/article/20180227/NEWS/180229926?utm_source=modernhealthcare&utm_medium=email&utm_content=20180227-NEWS-180229926&utm_campaign=am

States hedge their bets as they sue to end Obamacare

By Susannah Luthi  | February 27, 2018

One day after 20 states including Wisconsin sued to eliminate the Affordable Care Act, GOP Gov. Scott Walker visited two hospitals to hold ceremonial signings of a measure to spur a 1332 waiver application to stabilize the state's individual market.

It's a tale of of two tactical plans. While Wisconsin and other Republican-majority states have to work the political arena and appeal to conservatives to shore up their exchanges, they're also using the courts to dismantle the law.

But legal experts say the litigation's success is improbable because the states may not have standing to challenge the remainder of the ACA.

The states' lawsuit, filed Monday in a federal court in North Texas, claims that because the U.S. Supreme Court upheld the ACA in 2012 as a tax penalty, the law can't stand without it.

But the tax penalty isn't enforceable since the GOP tax bill from late 2017 zeroed out the mandate starting in 2019, according to legal scholar Timothy Jost. That fact doesn't give the states standing since Congress refused to repeal the rest of the statute and the request is "jaw-dropping," he said.

"Going to a judge and saying you need to do what Congress did not do — that is not what judges do," said Jost, who noted the states are essentially relitigating the case in a way that is likely "not going anywhere."

"They obviously don't know what they're talking about, that they want to repeal the entire statute," Jost said. "Does that mean the donut hole comes back for Medicare? Do 12 to 14 million people lose Medicaid coverage? Do 10 million people lose exchange coverage?"

Chris Condeluci, a health law consultant who worked as a GOP aide for the Senate Finance Committee while the ACA was written, said the step makes sense from a messaging perspective.

"I think it's a messaging case," Condeluci said. "It's a logical step that those who oppose the ACA would take."

Condeluci also pointed to past critics claims that U.S. Supreme Court Chief Justice John Roberts used the tax penalty argument in 2012 to avoid nixing the ACA, and noted the Supreme Court would likely use a separate provision to uphold the health law should they need to call up the case again.

Walker is one example of a plaintiff who is making this step while also working on his own stabilization plans.

"Gov. Walker did authorize the lawsuit because it questions the constitutionality of Obamacare," said Amy Hasenberg, a spokesperson for Walker.

However, Hasenberg continued, "ACA is the law and as long as it remains, Wisconsin will work within the confines of that law to help Wisconsin families. This is why Governor Walker created his Health Care Stability Plan which will help bring premiums down for those on the individual marketplace, and create stability for seniors and those with preexisting conditions."

Hasenberg also pointed out that should the plan would ensure coverage provisions for Wisconsin should the ACA ever be repealed.

Other plaintiffs include states that have expanded Medicaid such as Florida, Arizona and Louisiana — whose Democratic Gov. Jon Bel Edwards is an outspoken advocate for the ACA.

Several of the plaintiff states, including Indiana, Arkansas, Maine and Utah are working with the CMS on Medicaid waivers for work requirements that would ramp back Medicaid coverage in their states but not eliminate it entirely.

HHS Secretary Alex Azar, who is the defendant in the case because of his position at the helm of the department, has not yet released a statement about the case.

"HHS legal counsel and the Department of Justice will review the lawsuit and evaluate its arguments," an HHS spokesperson told Modern Healthcare on Tuesday.

Susannah Luthi covers health policy and politics in Congress for Modern Healthcare. Most recently, Luthi covered health reform and the Affordable Care Act exchanges for Inside Health Policy. She returned to journalism from a stint abroad exporting vanilla in Polynesia. She has a bachelor’s degree in Classics and journalism from Hillsdale College in Michigan and a master’s in professional writing from the University of Southern California.



Refusing To Work For Medicaid May Not Translate To Subsidies For ACA Plan

FEBRUARY 27, 2018

KHN contributing columnist Michelle Andrews writes the series Insuring Your Health, which explores health care coverage and costs.
To contact Michelle with a question or comment, click here.
This story also ran on NPR. This story can be republished for free (details).
Work requirements for Medicaid coverage. Insurance plans that don’t meet health law standards. Changes to Medicare drug lists. As the ground continues to shift on health care coverage, I answer readers’ queries this week about these three different types of plans.
Q: I’m in a state that is looking into work requirements for Medicaid. At sign-up time, can I simply tell the exchange that I intend to be ineligible for Medicaid by refusing to work and get the premium tax credit to buy a private plan on the insurance marketplace?
Federal health law regulations don’t clearly address the situation you describe, but the short answer is probably not, said policy analysts.
In general, people who are eligible for Medicaid — the federal-state health program for low-income people — or employer coverage can’t qualify for federal tax credits that help pay for premiums on plans sold on the health insurance exchanges.
This year, Kentucky and Indiana became the first states to receive federal approval to require some Medicaid recipients to put in 80 hours each month at a paid job, school or volunteer work, among other activities, to receive benefits. Nearly a dozen other states have made similar requests.
If you refuse to work, does that make you ineligible for Medicaid? The rules aren’t clear, said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities.
States might argue that someone in your situation is eligible for Medicaid, you just have to fulfill the work requirements, said Timothy Jost, an emeritus professor of law at Washington and Lee University in Virginia who is an expert on the health law.
Bottom of Form
There are other actions people could take — or fail to take — where this issue might come up. “You could argue that someone is not eligible because they haven’t completed the Medicaid application or provided the required documentation,” Jost said. “There are any number of requirements, but I can’t imagine someone saying they didn’t do those things and so they’re not eligible for Medicaid.”
Whatever the rules, it’s unlikely that many people will be in a position to consider taking this stance. To qualify for premium tax credits, your income must be between 100 and 400 percent of the federal poverty level (about $12,000 to $48,500 for one person in 2018). But you’d also have to be eligible for Medicaid, generally with an income limit of 138 percent of poverty (about $16,750) in states that expanded coverage to adults. In addition, the Medicaid work requirements in your state would have to apply to you.
Q: I lost my job last year and my employer coverage ended in January. I bought a new plan through the marketplace that went into effect last month. I just received policy information, and it states that because the plan does not cover major medical services, I may have to pay additional taxes to the government. I was told that the plan didn’t cover major medical but wasn’t told about any taxes. Will I be fined next year?
It sounds like you bought a plan that doesn’t comply with the Affordable Care Act’s requirements, and if that’s the case you may indeed have to pay a penalty for not having comprehensive coverage when you file your taxes next year.
The tax law repealed the individual penalty for not having health insurance, but that provision doesn’t take effect until 2019. So, for 2018, you may be charged the greater of $695 or 2.5 percent of your household income.
The federal- and state-run marketplaces established by the ACA sell only comprehensive plans that cover 10 essential health benefits, including “major medical” services like hospitalization and prescription drugs.
But some insurance broker websites call themselves marketplaces too, said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. These companies may sell other insurance products like short-term or accident coverage alongside comprehensive plans that comply with the law.
Ever since the health law was passed, “There have been opportunistic companies trying to take advantage of consumer confusion to make money,” Corlette said.
If you aren’t happy with your plan, you may still be able to switch. Losing your employer coverage qualifies you for a 60-day special enrollment period to pick a new plan. Since it appears you’re still in that window, you may be able to choose a comprehensive plan.
To ensure you’re using your state’s official marketplace, go to healthcare.govand click on “see if I can change.” That will take you to your state marketplace, even if you live in one of the dozen or so states that run their own exchanges.
Q: I picked a Medicare Part D drug plan that covered all the drugs I take. But as soon as I got my first Novolin R prescription filled, they notified me that they don’t cover it anymore. Can they just switch it like that?
Medicare drug plans can change their list of covered drugs, called formularies. If they’re doing so at the start of the new calendar year, as appears to have happened in your case, the plan may notify you of the change when you fill the prescription for the first time in the new year.  At that time, the plan would typically give you a 30-day “transition” refill so you can switch to another drug that’s on the formulary, according to Juliette Cubanski, associate director of the Program On Medicare Policy at the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)
If you and your doctor think it’s important that you have Novolin R and not another drug that is similar, you can ask your plan to make an exception to allow you to continue to take the medication.
To go that route, you would need to get your doctor to “make the case for why that formulary drug is not the right drug” for you, said Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center, an advocacy group.
Michelle Andrews: @mandrews110


Quote of the Day

"Whoever gets in the position to do something, the industry will apply pressure on [him or her]. They were not applying pressure on Trump when he did not look like he was going to win."


— Health care analyst William Pewen, who played a role in developing the Senate Finance Committee's health reform bill during the Obama administration, tells AIS's Health Plan Weekly about why pharmaceutical industry donations to President Trump suddenly skyrocketed last year. 

2,058,861 is the number...

...of lives enrolled in L.A. Care Health Plan, the largest publicly operated insurer in the country. Its Medicaid HMO plan has 2,014,612 beneficiaries in California, leading the state's Medicaid market with a 17.6% share.

Blues Plans' New Strategies to Break Into Medicaid Managed Care


More and more Blue Cross and Blue Shield plans are renting capabilities or buying companies with Medicaid-specific expertise to compete in the Medicaid space.

Several Blues plans tried to break into Medicaid managed care over a decade ago, yet failed, as "they didn't appreciate all the adjustments they had to make to succeed in that business," says Bob Atlas, president of health care strategy consulting firm EBG Advisors.

Now Blues plans are turning to partner on Medicaid with companies like Anthem, Inc. subsidiary Amerigroup Corp. and the AmeriHealth Caritas Family of Companies, rather than develop the infrastructure in-house.

For instance, BlueCross BlueShield of Western New York is using its Amerigroup partnership to expand Medicaid business into Niagara and Genesee counties. Its plan has covered 31,000 members in Child Health Plus and another 28,500 members in Medicaid managed care.

Florida True Health, a joint venture of Florida Blue and AmeriHealth Caritas, serves Medicaid members in 55 of the state's 67 counties. Blue Shield of California bought Care1st Health Plan in 2015, which has 473,000 Medicaid beneficiaries at the time of acquisition, to foray into California's Medicaid program.

Yet not all Blues plans that are active in the Medicaid business rely on partnerships. For instance, BlueCross BlueShield of Tennessee has operated in the TennCare Medicaid managed care program for more than two decades. Anthem is also expanding its Medicaid coverage in Wisconsin, becoming the first Medicaid plan that serves the entire state.


Subscribers may read the in-depth article online. Learn more about subscribing to AIS Health's publications.

Integrity Marketing Group Expands National Footprint with Acquisition of Arizona-based Western Penn Marketing

Integrity_WesternPenn-LOGO

Integrity Marketing Group Expands National Footprint with Acquisition of Arizona-based Western Penn Marketing


DALLAS February 28, 2018 — Integrity Marketing Group, LLC (“Integrity”), announced today that it has completed the acquisition of Western Penn Marketing (“Western Penn”), a Mesa, Arizona-based company focused on selling life and health insurance to the Senior Market. Ted Ruttinger, owner and CEO of Western Penn, has become an owner in Integrity as part of the deal. Financial terms of the private transaction were not disclosed.

Founded in 1987, Western Penn specializes in marketing Medicare Supplement and Medicare Advantage plans throughout the United States. The combined business expands Integrity’s national footprint with a market-leading agency in key markets including Arizona, Utah, Colorado, and Oregon. All employees of Western Penn will maintain their current roles with the company and will continue to operate under the Western Penn brand.

Western Penn is a long-time Diamond Partner of AIMC, a company Integrity acquired in 2017. This partnership allows Western Penn to grow and expand more rapidly with access to more insurance carriers and more services to offer to their agents.

“When AIMC joined Integrity, I knew I wanted to be part of this amazing organization that Mike White and other Senior Market leaders were building together,” Ruttinger said. “Integrity has the technology, marketing systems and carrier contracts that will help Western Penn agents take our business to the next level. Scale is important to be successful today and I am excited to join the team.”

“It’s great to now be equity partners with Ted after working with him for over 30 years,” said Mike White, CEO of AIMC and Managing Partner of Integrity. “The platform we are building allows entrepreneurs like Ted and myself to diversify our personal assets by taking some chips off the table, while significantly growing the business at the same time.”

Western Penn brings a wealth of regional expertise in the Southwest where there is a large population of Seniors that are in need of the products Integrity offers, and a proven track record which is evident by its deep and long-lasting relationships with the agents and agencies that it serves.

“Ted and his team have built an incredible business around providing the highest level of service to agents, and we are excited to welcome Western Penn to the team of Integrity companies,” said Bryan W. Adams, Co-Founder & CEO of Integrity. “It is an honor to have another thought leader in Ted who shares our vision as we continue to look for owners of quality businesses to join our partnership.”

# # #

About Integrity Marketing Group
Integrity Marketing Group, headquartered in Dallas, Texas, is the nation’s leading independent distributor of life and health insurance products focused on serving the Senior Market. Integrity develops and distributes life and health insurance products with insurance carrier partners and markets these products through its distribution network, which includes other large insurance agencies located throughout the country that have almost 130,000 independent agents. Integrity serves nearly one million clients with almost 300 employees. In 2017, Integrity helped insurance carriers place over $750 million in new premium. More information is available at www.IntegrityMarketing.com.

Media Contact:
Gabriel Ross
Stanton
646-502-3576

Integrity Contact:
Eric Pederson
Vice President of Business Development
Integrity Marketing Group, LLC

Tuesday, February 27, 2018

New Medicare Card Project

Centers for Medicare & Medicaid Services

Long-Term Services and Supports

WEBINAR

Sample of new Medicare Cards

New Medicare Card Project

Wednesday, February 28, 2018

From April 2018 to April 2019, older adults will receive new Medicare cards from CMS. To help protect elders from identity theft, these new cards will replace social security numbers with Medicare numbers that are unique to each beneficiary.
Follow the CMS Medicare messaging guidelines (PDF, 106 KB, 3 pp) to share these changes with elders in your community. To help prevent identity theft, remind elders to guard their cards.

This webinar focuses on the implementation of the new Medicare card and its impact throughout Indian Country.
Objectives:
  • Why CMS is undertaking this project
  • What the Medicare Beneficiary Identifier (MBI) is
  • How CMS will transition from the old number (HICN) to the MBI
  • What providers should do to get ready for the new MBI
  • How this project impacts Native Americans
  • How CMS outreach efforts increase awareness
Have questions for our presenter? Let us know before the webinar by emailing ltssinfo@kauffmaninc.com, or during the webinar.
Text Box: Register

Text Box: More information

Please note your
location's call-in time:
9 a.m. Hawaii
10 a.m. Alaska
11 a.m. Pacific
12 p.m. Mountain
1 p.m. Central
2 p.m. Eastern
Presenters
Marni Land
Senior Technical Advisor
Centers for Medicare and Medicaid Services
Office of Information Technology
Division of Program Management
Susy Postal
Chief Health Informatics Officer
Indian Health Service

Once you’ve registered and the Overview page is open, please ensure the best webinar experience by testing your system or downloading the Flash Player ahead of time.
Watch past webinars on the Centers for Medicare & Medicaid Services website.


LTSS Training and Technical Assistance Center
Visit the online Center for information, trainings, videos, program models, best practices, a resource library, and a step-by-step planning roadmap.

LTSS Partners
Centers for Medicare & Medicaid Services | Indian Health Service | Administration on Community Living