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Department of Health and Human Services
The National Advisory Committee on Rural Health and Human Services
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Letter to the Secretary: September 12-14, 2007, Madison, Wisconsin

October 16, 2007

The Honorable Michael M. Leavitt
U.S. Department of Health and Human Services
200 Independence Ave, SW
Washington, D.C. 20201

Dear Secretary Leavitt,

I would like to share with you findings from the most recent Committee meeting in Madison, Wisconsin on September 12-14, 2007. As you know, each year the Committee conducts two meetings in the field to speak with local rural health and human services experts, in order to glean information for the Committee’s Annual Report.

The Committee visited Madison and Sauk City, Wisconsin, to gain a local perspective for the 2008 Report. We heard from a number of local and State health and human service experts and also had the opportunity to visit the Rural Wisconsin Health Cooperative in Sauk City. During that portion of the meeting, the Committee heard from the director of a State-wide Child Poverty Council, a representative from the Ho-Chunk Nation, and the director of a rural Community Health Center, among others. The Committee looks forward to sharing the findings from the site visits with you in the 2008 Report.

The Committee also heard from Wisconsin State Insurance Commissioner Sean Dilweg, who detailed some of the challenges experienced during the initial implementation of Medicare Advantage (MA) Private Fee-for-Service Plans in Wisconsin. The Commissioner described inappropriate and confusing insurance marketing and enrollment practices. The Committee felt that this was important information that should be shared with you right away. Commissioner Dilweg noted that the problems have arisen in the implementation of MA because States do not have jurisdiction to take action against abuses. He noted that these issues could have been addressed if State Insurance Commissions had more authority to regulate the MA plans, similar to the way States have long regulated supplemental Medigap insurance plans. Such a step would be consistent with past cooperation and coordination between State and Federal regulators. It would also be consistent with this Committee’s recommendations pertaining to rural MA in the 2007 Report.

A draft of the 2008 Report will be finalized over the upcoming months. The next Committee meeting will take place in Washington D.C., from February 20-22, 2008. Thank you again for your support of the Committee and of rural America.


The Honorable Larry K. Otis Sr.