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Medicare / Medicaid / SCHIP News

New York Times Examines Efforts To Stop Deceptive Marketing Practices For Medicare Advantage Plans

Main Category: Medicare / Medicaid / SCHIP
Article Date: 18 Dec 2007 - 8:00 PDT

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The New York Times on Monday examined deceptive or fraudulent practices used by insurance agents to enroll older U.S. residents in Medicare Advantage plans. In an effort to stop deceptive practices, the Bush administration has instructed insurers to "monitor their agents more closely, several companies have been fined, and the government sends 'secret shoppers' to some advertised sales events to check the accuracy of agents' statements," according to the Times. Acting CMS Administrator Kerry Weems said, "There are substantially fewer violations, and those violations are of substantially lower severity than in previous marketing periods."

However, insurance experts say that the "extent of the problem almost surely exceeds official data because many victims never file complaints or report their experiences," the Times reports. "Compounding the problem, many agents sell Medicare Advantage plans for two or more insurance companies, and some work for independent marketing organizations, so the lines of responsibilities may be blurred," according to the Times.

In addition, the Times notes that although states "license insurance agents ... they have a limited ability to regulate the private Medicare plans." L. Darriel Pulliam -- an insurance agent in Columbus, Miss. -- said, "Medicare has a pile of new rules, but the rules are not making a heck of a lot of difference" (Pear, New York Times, 12/17).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.




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