Medicare Insurance Plans Temporarily Suspend Marketing

The Centers for Medicare and Medicaid Services (CMS) announced June 15, 2007 that in response to concerns about marketing practices, seven health care sponsors have signed an agreement to suspend voluntarily the marketing of Private-Fee-For-Service (PFFS) plans. This suspension will be lifted only when CMS certifies that the plan has the systems and management controls in place to meet all of the conditions CMS has set forth. The companies include: United Healthcare, Humana, Wellcare, Universal American Financial Corporation (Pyramid), Coventry, Sterling, and Blue Cross/Blue Shield of Tennessee.
“While we note that most health insurance agents are helpful and responsible in describing and explaining choices to beneficiaries, there are a few bad actors that need to be removed from the system for good,” said Leslie V. Norwalk, Esq., Acting Administrator of CMS. “This voluntary agreement demonstrates that CMS and the plans are stepping up to ensure that deceptive marketing practices end immediately, and that beneficiaries understand what they are purchasing.”
“Through a variety of methods, including our ‘secret shopper’ program that uses trained individuals to attend marketing events and report back on the insurance agents’ activities, and the eyes and ears of our thousands of partners throughout the nation, CMS is proactive in protecting beneficiaries from rogue agents. Although the 2700 agent complaints we logged from December 2006 to April 2007 represent less than one half of one percent of the 1.3 million members enrolled in individual PFFS plans, we can always do better,” added Norwalk.

This is a case where the message is being adversely impacted by the actions of unethical messengers. I represent many of these private Medicare plans. I have helped many seniors save money while ensuring comprehensive healthcare coverage. One of my clients is saving $150 per month while benefiting from wellness services she previously did not have. Growth in these plans has been significant(currently 8.3 million members) , not because they are being oversold, but because it meets a need. Strict regulations will hopefully force many unethical agents from the business. These plans are here to stay, giving seniors many more options for health insurance coverage. This can only serve to benefit seniors over the course of time. Speculation is that these plans will be available again during open enrollment later this year, November 15, 2007. I will keep you posted.