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欧博平台怎么打赢:Warnings of Medicare fraud mount – here is how to avoid it

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“Information submitted by states demonstrates that beneficiaries are inundated with fraudulent and misleading communications across all modes of communication (in-person, television, telemarketer, and robo-calls,” the Senate committee report states. – Reuters

A new report from the US Senate Finance Committee documents a range of fraudulent and misleading marketing practices used to sell Medicare Advantage plans – and some of them are real eye-openers.

A Medicare Advantage promotional mailer designed to look like a form from the Internal Revenue Service.

A “Medicare bus” trundling around Ohio advertising an Internet address that takes users to an insurance brokerage website.

Insurance agents accosting seniors in grocery store parking lots, or making enrollment pitches to vulnerable seniors who have cognitive impairment.

The committee solicited input from state insurance commissioners and the national network of State Health Insurance Assistance Programs (SHIP), which assists seniors with Medicare enrollment.

The findings come on the heels of a report by the Centres for Medicare and Medicaid Services (CMS), which runs Medicare, that it received 39,617 complaints about the marketing of Medicare Advantage and Part D drug plans in 2021 – a dramatic increase of 155% compared with the number of complaints received in 2020.

The Senate report is especially timely, since it lands in the midst of the annual Medicare open enrollment season.

This is the time of year when seniors can make changes in their health insurance choices – and also must be prepared for a barrage of advertising and marketing pitches.

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Commercial insurers market both Part D and Medicare Advantage plans. But the report found that the deceptive practices are most prevalent with Advantage, the commercially offered managed-care alternative to traditional fee-for-service Medicare.

At the centre of the problem are third-party marketing organisations that contract with the insurance companies that run Advantage plans. “Information submitted by states demonstrates that beneficiaries are inundated with fraudulent and misleading communications across all modes of communication (in-person, television, telemarketer, and robo-calls,” the Senate committee report states.

The investigation turned up a wide range of predatory marketing, including:

> Agents who sign up beneficiaries under false pretenses, such as telling them that coverage networks include healthcare providers who are not actually in the networks.

> Agents who change the plans of seniors and people with disabilities without their consent.

> Targeting low-income individuals who are eligible for both Medicare and Medicaid (so-called dual eligibles, who are allowed to switch Advantage plans once every quarter.

A crackdown is needed

CMS announced new rules earlier this year aimed at curbing deceptive advertising practices by third-party marketers. But the Senate report urges CMS to do more.

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