Senate Finance Committee Chairman Max Baucus (D-Mont.) has requested more information about the recent marketing moratorium of private fee-for-service plans by seven major companies that offer Medicare Advantage options. In letters sent June 25 to the CMS and Americas Health Insurance Plans, Baucus asked, in part, about the events that triggered the suspension, how the CMS plans to strengthen its oversight and what improvement insurers would recommend to the private fee-for-service program.
Im going to ask a lot of questions of a lot of folks to make sure seniors come first in the private fee-for-service program, he said.
Meanwhile, House members heard today that complaints about the Medicare Advantage program have outpaced all other insurance industry complaints in Mississippi, including those over Hurricane Katrina, according to Lee Harrell, deputy commissioner of the Mississippi Insurance Department.
Harrell, joined by healthcare advocates and state officials from Alabama, California and the District of Columbia provided a laundry list of misleading and possibly fraudulent sales techniques that contracted agents used in order to switch vulnerable seniors out of traditional Medicare and into the much more lucrative Medicare Advantage products, including private fee-for-service plans.
Witnesses described to members of the House Energy and Commerce Subcommittee on Oversight and Investigations sales incentives such as big-screen televisions, high-dollar prizes and trips to Las Vegas that were used to entice salespeople to enroll seniors into such plans.
David Lipschutz, staff attorney for California Health Advocates, a Medicare beneficiary advocacy group, said that the CMS voluntary moratorium on marketing of private fee-for-service plans does not go far enough to stop such practices. Lipschutz said that mandatory training with standardized curricula and testing is needed. From a federal standpoint, Lipschutz said that members of Congress should achieve payment parity between Medicare Advantage plans, which are paid more per beneficiary than traditional Medicare. He also called on lawmakers to minimize the commission structure.
But Abby Block, CMS director of the Center for Beneficiary Choices, defended the agencys week-old moratorium, which includes the top seven sellers of Medicare private fee-for-service plans. In testimony, Block called the measure meaningful and precedent-setting and indicates how important good practices are both for the CMS and the industry. -- by Matthew DoBias