House leaders called for an investigation of the insurance company Health Net, Woodland Hills, Calif., for allegedly pressuring senior citizens into enrolling in certain Medicare Advantage plansa violation of recently passed federal laws and regulationsand potentially trying to defraud the Medicaid program.
In letters sent to HHS secretary and inspector general, as well as Health Net President and Chief Executive Officer Jay Gellert, House Energy and Commerce Committee Chairman John Dingell (D-Mich.) cites the use of automated phoning, or robo-calls, that led seniors to sales agents who provided misleading information regarding the private plans that operate within the Medicare program.
The alleged abuses were reported by the not-for-profit National Senior Citizens Law Center, a legal services group that assists low-income senior citizens. In its complaint, the NSCLC alleges that sales agents gave incorrect information about plan restrictions, enrollment deadlines and whether they would lose Medicare drug benefits or Medicaid benefits if enrolled. Additionally, the sales agents implied that they could enroll the prospective seniors during the outbound call, which Dingell states is expressly prohibited by federal law.
Perhaps more troubling, Dingells letter to federal health officials cites instances where Health Net agents allegedly posed as beneficiaries in order to obtain Medicaid identification numbers. Heath Net officials did not provide comment by deadline. (For a longer version of this story, please click here.) -- by Matthew DoBias