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State Insurance Official Testifies Before Congress on Abusive Medicare Advantage Sales Practices

From: Office of the State Insurance Commissioner      Filed 6/26/07   GCN

Deputy Insurance Commissioner Lee Harrell testified before a Congressional sub-committee today on the problems Mississippi faces regarding the spread of abusive Medicare insurance sales practices. Harrell was joined by fellow state regulators Commissioner Kim Holland of Oklahoma, and Commissioner Jim Poolman of North Dakota, in testifying before the House Energy & Commerce - Oversight and Investigations Subcommittee at a hearing on "Predatory Sales Practices in Medicare Advantage."

"Mississippi takes seriously its duty to protect its consumers while promoting a healthy insurance market, but the way the current Medicare Advantage system is designed, we are precluded from fully meeting that duty. We must work together to protect our Senior Citizens," Harrell said in opening remarks.

He told the committee that the Mississippi Insurance Department (MID) had received as many as 1,000 complaints from consumers, not including complaints that have been filed with other state agencies such as the Mississippi Department of Human Services (MDHS).

Also, when asked the difference between problems that evolved in selling other products and Medicare Advantage plans, Mr. Harrell replied, "Just look at the victims, the elderly, and the ill that may or may not have the physical or mental ability to make informed decisions about these products."

Harrell stressed that while these plans could be beneficial to some people and not all agents are engaging in these deceptive practices, the difficulties lay in the fact that the states have regulatory authority over the agents but possess no authority over Medicare Advantage plans, which are subject solely to federal jurisdiction. He urged the committee to give states the regulatory authority over Medicare Advantage plans by allowing states to enforce federal minimum standards, much like Congress did in the 1990's when similar problems arose with Medigap plans.

Harrell also testified that another major problem in this growing nationwide issue, is inadequate training of agents. He noted that the company which touts the best training of its agents provides only 10 hours of training-all in one sitting.

"Despite limited jurisdiction, Mississippi has been as proactive as possible by educating recipients and helping victims get disenrolled from Medicare Advantage Plans and re-enrolled in Medicare Parts A and B," Harrell said.

The MID continues to receive complaints where some Medicare recipients are being enrolled in these plans without fully understanding their terms, and in some cases, without even knowing they have been enrolled. All Medicare recipients and their family members are urged to be vigilant when selecting a Medicare Part C or Part D plan, and if an agent uses abusive sales practices, to contact the MID immediately.

Among the abusive Medicare Part C and D practices being reported are door-to-door solicitations. Conducting a door-to-door solicitation or outreach prior to being invited by a Medicare recipient is prohibited. If someone comes to the door without having been invited, the recipient should not let them into the home. Also, recipients should do not give that person any information or let him or her see any of your personal documents. The recipient should not sign anything for that person.

Anyone who suspects they have been the victim of abusive Medicare Insurance sales practices is urged to contact MID as soon as possible at 1-800-562-2957. For any other questions regarding Medicare Part C and D policies, they should contact MDHS at 1-800-948-3090.

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