Accountability and Transparency in Medicare Marketing Act of 2007

Floor Speech

ACCOUNTABILITY AND TRANSPARENCY IN MEDICARE MARKETING ACT OF 2007 -- (Extensions of Remarks - December 19, 2007)

HON. KATHY CASTOR
OF FLORIDA
IN THE HOUSE OF REPRESENTATIVES
TUESDAY, DECEMBER 18, 2007

* Ms. CASTOR. Madam Speaker, I am proud today to introduce the Accountability and Transparency in Medicare Marketing Act of 2007. This legislation will serve as a companion bill to S. 1883, introduced in the Senate by Mr. Herb Kohl.

* With recent reports from the Government Accountability Office addressing the failure of CMS to audit Medicare Advantage providers along with recent reports of marketing abuses and fraudulent practices aimed at seniors, this legislation is timely and imperative.

* We have heard reports that many Medicare providers seek to mislead seniors for private financial gain. In fact, seniors are frequently confronted with such practices as cold calling, misleading sales pitches to purchase unnecessary products, or being pushed to enroll in private Medicare Advantage programs that are not within their best interests.

* WellCare Health Plans, which is headquartered in my hometown of Tampa, was raided by the FBI in October for suspected fraudulent practices. WellCare is among the largest national providers of Medicare and Medicaid managed care plans with 2.3 million members nationwide.

* Three quarters of states have reported complaints about inappropriate or confusing marketing practices which lead Medicare beneficiaries to enroll in private plans without adequately understanding the consequences of their decision or that Medicare Advantage is optional.

* Some seniors have lost access to their regular doctors after signing up for a private plan that their doctor does not accept. However, when sold the plan, the private company assured that this would not occur.

* Frighteningly, some providers have been accused of selling to seniors with dementia and using scare tactics to force beneficiaries to enroll. Others have been offered cash incentives for enrolling.

* All of these scams and efforts to mislead seniors for private financial gain are a result of the lack of standardized regulations and real accountability. It has been reported that the government pays private Medicare Advantage insurers an average of $9,000 a year for each person enrolled. Private insurance agents receive between $350 and $600 commission for each person they enroll. With nearly nine million Americans currently enrolled in these private plans, the profits going to these insurers and away from America's health care system is astronomical.

* Without a standard method used for regulation, the financial gain of private insurers will continue to rise at the health expense of seniors and the personal and financial stress of all Americans.

* We must implement transparency requirements that will ensure companies are held accountable and publicly identified, in the event of marketing abuses. The Accountability and Transparency in Medicare Marketing Act of 2007 will address all of these issues. It will create standardized marketing practices to be enforced by the National Association of Insurance Commissioners (NAIC). These standard practices will exclude telemarketing and cold calling, deceptive selling and other abusive practices.

* This bill will create transparency by requiring that all violations be reported to the Secretary of Health and Human Services and in turn reported to Congress.

* Additionally, this legislation will require the NAIC to create a committee to study and make recommendations to the Secretary and Congress on the establishment of standardized benefit packages for Medicare Advantage plans.

* This legislation will help us to continue our effort to make Medicare safe, beneficial and accountable to our seniors, family care givers and all Americans. It will enforce regulations that will demand ethical and helpful tactics. It will alleviate private insurers unfairly benefiting from the hard-earned dollars of all American families. Further, we will provide seniors and family care givers with the protection and care that they deserve. It is our responsibility to keep fraud and unethical practices from plaguing our health care system, and the Accountability and Transparency in Medicare Marketing Act of 2007 seeks to help us step up to this duty.

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