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Abuses in Enrollment Tactics Found for Private Medicare
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"That does not sound like WellCare-authorized material," said John Aberg, a company spokesman. "Our compensation is in line with other carriers."
Aberg said WellCare will emphasize in Senate testimony today that "we have a very strong compliance program in place . . . that could serve as a model."
Karen Ignagni, president of America's Health Insurance Plans, a trade group, said yesterday that its members will clamp down. Proposals include new qualifications, training and safeguards to ensure that beneficiaries understand the plans.
"We're going to be talking about zero tolerance," Ignagni said. "If this is happening anywhere, we need to address it."
Burns from the California group agreed. She attended a sales meeting in her state in which agents were "more interested in the commission than the information given to the beneficiary," she said.
One agent from Alameda County said at the meeting that she "had sold a number of these plans only to find out that the entire county health-care system would not accept the plan," Burns said.
In Los Angeles County alone, Burns said, sales agents pitch 109 Medicare Advantage options. "People are just totally flummoxed," she said.
Leslie V. Norwalk, acting administrator of the Centers for Medicare and Medicaid Services (CMS), said any program that spends $454 billion a year, as Medicare does, is bound to attract fraud. The agency allows beneficiaries to drop plans that they were duped into joining and suspends enrollments, fines the companies or revokes their ability to sell the plans, Norwalk said.
The CMS received more than 650 complaints about marketing abuse between December and March of this year. The agency has an agreement with about 20 states to share information about problem agents and brokers, Norwalk said. But in light of more widespread abuse, she said, "the question is: Does it need to be tweaked?"
