U.S. Senate Panel Examines Marketing of Medicare Plans
The Senate Special Committee on Aging on Wednesday plans to hold a hearing to address unethical or illegal practices that some sales agents reportedly have used to enroll Medicare beneficiaries in private Medicare Advantage plans, the San Francisco Chronicle reports (Colliver, San Francisco Chronicle, 5/16).
In advance of the hearing, Senate investigators released to Congress interviews and documents that indicate sales agents in at least 39 states have used unethical or illegal practices. Such practices have included the enrollment of dead or mentally incompetent Medicare beneficiaries, the impersonation of Medicare representatives and the use of personal information stolen from federal records, according to Senate investigators.
In addition, Senate investigators "have found that improper sales practices inspired by insurers offering high commissions have drawn civil and criminal cases, damaging the credibility of a program that some have called a model for revamping the Medicare system," the Washington Post reports.
Leslie Norwalk, acting administrator of CMS, said that any program as large as Medicare will attract fraud. Norwalk also said that CMS allows Medicare beneficiaries to leave plans in which they enrolled because of unethical or illegal practices by sales agents and penalizes health insurers involved with the practices with fines, suspensions of enrollment or revocation of the ability to sell fee-for-service plans.
The agency last week decided to require private Medicare fee-for-service plans to call beneficiaries prior to enrollment to ensure that they understand the plans and have decided to enroll in them.
Senate Special Committee on Aging Chair Herb Kohl (D-Wis.) said, "There's a lamentable lack of oversight when it comes to the sales practices being used to sell Medicare Advantage plans to our seniors." Kohl added, "Our goal is that these plans must be represented in a transparent, honest and fair way."
Karen Ignagni, president of America's Health Insurance Plans, said, "We're going to be talking about zero tolerance" at the hearing. Ignagni said that proposals include new qualifications and training for sales agents, in addition to increased protections to ensure that Medicare beneficiaries understand the plans in which they enroll (Williamson/Lee, Washington Post, 5/16).
Robert Hayes, president of the Medicare Rights Center, said, "It's time the administration paid attention to this. We're swamped with people reporting abuse, fraud and misrepresentation." Hayes added, "It's a Wild West market" (San Francisco Chronicle, 5/16).