The CMS is readying a proposed rule that would facilitate oversight of Medicare Advantage and Part D prescription drug plans to better detect, prevent and correct fraud and abuse within the programs, an agency official told members of Congress today.
At a hearing of the Senate Special Committee on Aging, Abby Block, director of the Center for Beneficiary Choices at the CMS, said that the proposed regulation would speed the federal agencys ability to move against those private plans that operate within Medicare using illegal or deceptive sales tactics to boost beneficiary enrollment.
The hearing centered on a congressional investigation that found questionable sales practices, such as removing seniors from traditional Medicare without their knowledge or enrolling beneficiaries in plans that they could not afford, were rampant among sales agents across the country.
Our investigation has revealed a disturbingly consistent picture, one which only seems to be growing, Committee Chairman Herb Kohl (D-Wis.) said. Countless seniors purchasing Medicare Advantage plans have been preyed upon and unwittingly taken advantage of by insurance agents.
So far this year, the CMS has levied about $400,000 in civil monetary fines against plans found in violation of Medicare marketing rules.
Meanwhile, Americas Health Insurance Plans, representing roughly 1,300 plans, today unveiled new guidelines its member organizations are expected to follow, which include a series of callbacks to beneficiaries to verify the appropriateness of any plan and to ensure the terms of the plan are understood. -- by Matthew DoBias