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US Cracks Down on Some Medicare Plan Marketing 

 

Reuters Health

 

June 18, 2007


UnitedHealth Group Inc., Humana Inc., Wellcare Health Plans Inc. and four other companies agreed to suspend marketing of private fee-for-service Medicare plans because of complaints of deceptive practices by some of their agents, the U.S. government said on Friday. 

 

These increasingly popular plans offer access to any doctor or hospital eligible to receive Medicare payments that will accept the conditions of the particular plan. Medicare is the federal health insurance plan for the elderly and disabled. The base plan pays for many health services but does not pay all costs or cover all services. 

 

The Centers for Medicare and Medicaid Services (CMS) said a total of seven companies would halt marketing and sales events to sell their private fee-for-service Medicare plans to individuals until they demonstrate they have mechanisms in place to ensure agents accurately describe and sell their products. The companies, which sell 90 percent of all private fee-for-service plans, also include Universal American Financial Corp., Coventry Health Care Inc., Sterling Life Insurance Co. and BlueCross BlueShield of Tennessee, CMS said. 

 

Consumers can still enroll in private fee-for-service plans by contacting the insurance companies during the marketing suspension, the CMS said. The agency said it received 2,700 complaints of agents using deceptive techniques during a recent five-month period. The complaints came via the agency's toll-free telephone line, regional offices, congressional staff and news reports. The complaints represent less than one-half of 1 percent of the 1.3 million people enrolled in private fee-for-service plans, the CMS said. 

 

Abby Block, director of CMS's center for beneficiary choices, said some "rogue agents" may have encouraged confusion and misperceptions about the private fee-for-service plans. "While most agents and brokers are helpful in explaining choices and options to beneficiaries, there are a few bad apples that need to be removed," Block told reporters. 

 

Humana said in a statement that its voluntary suspension of marketing would have a modest impact on sales. The company estimated the action would affect its overall 2007 earnings by no more than 2 cents per share. 

 

A health insurance industry group said it had efforts underway to train brokers, agents and marketing staff to give accurate and clear information to potential customers. 

 

"We have urged the development of clear guidelines for health plans to report serious broker-agent misconduct to CMS and the states," said Karen Ignagni, president of the America's Health Insurance Plans. 


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