Acting CMS Administrator Weems Participates In 'Secret Shopper' Program Monitoring Medicare Advantage Plan Marketing

Main Category: Medicare / Medicaid / SCHIP
Article Date: 28 Nov 2007 - 8:00 PDT

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As part of a CMS initiative to investigate the sales tactics of insurance agents marketing Medicare Advantage plans to seniors, acting agency Administrator Kerry Weems on Wednesday attended a promotional presentation for an MA plan as a "secret shopper," the AP/Contra Costa Times reports. Weems posed as a customer seeking information on behalf of his mother. Participants in the agency's secret shopper program, which includes private contractors as well as CMS staff, this year have attended 119 presentations conducted by 56 participating agents.

Earlier this year, congressional hearings showed that while many seniors are pleased with their benefits under MA plans, marketing abuses have occurred in some cases. In response to the increasing pressure from advocacy groups and lawmakers, CMS enacted several changes to marketing and sales practices, according to the AP/Times. Agents must call beneficiaries who have enrolled in certain plans to ensure that they understand the terms of the coverage. Agents also have to pass a written exam indicating they understand Medicare policies, and they must inform CMS officials about scheduled sales and marketing presentations and events.

Weems said the oversight initiative in recent months has indicated that the number and extent of problems with MA plan marketing have declined. He said of the secret shopper program, "It's a serious effort. It's not a game of gotcha, and it's not a publicity stunt" (Freking, AP/Contra Costa Times, 11/27).

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