Private health insurance plans misled customers into signing up, says Senate report

Senate Democrats' report highlights widespread misconduct by plans and the marketing companies they hire.

Companies that sell private health insurance plans to seniors impersonated the Internal Revenue Service and other government agencies, misled customers about size from their networks and preyed on vulnerable people with dementia and cognitive impairment, according to a new investigation into deceptive marketing practices in the industry released Thursday by the Senate Finance Committee Democrats.

Many people say they have been enrolled in diets without realizing it.

The report lists complaints from 14 states and a multitude of marketing materials generated by ass urers and the companies they hire to help sell the private plans.

The plans are part of a program called Medicare Advantage which now enrolls nearly half of all Medicare beneficiaries. The committee says people both in traditional health insurance and those already in private plan have been inappropriately displaced.

"It is unacceptable that this magnitude of fraudsters and scammers are showing up amok in Medicare, and I will be working closely with C.M.S. to ensure this dramatic increase in marketing-related complaints is addressed,” said Ron Wyden, Democratic Senator from Oregon. and chair of the committee, referring to the Centers for Medicare and Medicaid Services, the agency that oversees Medicare."Medicare Advantage provides valuable plan options and additional benefits to many seniors, but it is essential to stop any tactics or actor who harms seniors or undermines their confidence in the program."

Medicare Advantage has become a very lucrative market for health insurers. But many insurers selling such plans have been accused of exaggerating their customers' illness, according to a New York Times study last month that found four of the top five insurers faced federal lawsuits accusing them of fraud.

< p class="css-at9mc1 evys1bk0">"Because it's such a profitable line of business, they have an incentive to do more marketing," said Tricia Neuman, senior vice president from the Kaiser Family Foundation, which is working on a review of television commercials by the plans. "And they have more money to do marketing, which increases revenue."

Most of the behavior documented in the report came from insurance brokers or third-party marketing companies hired by the companies, not the insurers themselves.

The Senate report did not specify which insurers benefited from the behaviors described. But he identified similar deceptive behavior in several states and a growing number of complaints, suggesting the tactics weren't limited to a small group of bad actors.

Industry trade groups have denounced the practices.

"America's elderly and disabled people deserve Medicare Advantage (MA) plans that continue to provide better services, better access to care and better value," Kristine Grow, spokesperson for AHIP, an industry trade group, said in a statement. "Health insurance providers are clear: Americans must be protected from bad actors who engage in deceptive advertising and marketing tactics."

She emphasized strict federal government oversight of industry marketing, including new rules that will require brokers to record their calls with potential customers and provide greater oversight of third-party marketing groups signing up new customers. p>

The Senate report highlighted several aggressive practices it said constituted fraud.

Five states said were aware of brokers who had targeted people with dementia, and six states reported that people had signed up for a Medicare Advantage plan without even knowing it.

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