Insurance agents trying to sell Medicare Advantage private fee-for-service plans may be walking on eggshells these days. They never know if a CMS mole may be listening to every word they say.
Earlier this year, the CMS enacted a secret shopper program, whereby hired contractorsand sometimes agency officials themselvespose as potential customers and listen in on agents presentations to Medicare beneficiaries, to make sure that the information they provide on Medicare Advantage fee-for-service is on the up and up.
Kerry Weems, the agencys acting administrator, has sat in on at least three presentations so far, posing as a prospective customer. (Once, he was busted by a salesman who thought the caller knew just a little too much about Medicare.)
Weems says that the CMS started the program to monitor potential marketing abuses that are particular to Medicare Advantage fee-for-service plans. In fact, several violations occurred during the first presentation he attended in Illinois, where he posed as a customer looking into a plan for his mother. In one instance, the agent said that seniors could go to any physician they wanted under Medicare Advantage fee-for-service, and thats not accurate, Weems says. The doctor has to agree to accept payment from the plan first.
Weems estimates that the program has covered 119 events to date. Most of the work is conducted by an outside contractor, but Weems says that he and other senior CMS officials have attended these presentations, in addition to some regional officers.
This isnt about snagging these companiesin the end, its to help them improve their marketing program, Weems says. Improvements have already been reported; the Illinois plan, for example, has retrained all of its agents in how to market its products.