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Opening Statement of Chairman Bart Stupak Oversight & Investigations Subcommittee “Predatory Sales Practices in the Medicare Advantage Program” June 26, 2007
Opening Statement of Chairman Bart Stupak Oversight & Investigations Subcommittee “Predatory Sales Practices in the Medicare Advantage Program” June 26, 2007 Our hearing will examine the program known as “Medicare Advantage” which provides insurance options for Medicare beneficiaries. One of its primary objectives was to provide Medicare beneficiaries a wide array of managed care choices. However, the proliferation of private Medicare insurance plans has come at a price. Investigators forthis Committee have verified countless stories of deceptive sales practices by insurance agents who prey upon the elderly and disabled to sell them expensive and inappropriate private Medicare plans. These shameful marketing practices, targeting our most fragile and vulnerable citizens, are the subject of today’s hearing. As often happens in the process of our investigation - usually just before this Subcommittee holds a hearing - those being investigated make a changes in their practices to appear as though they are addressing the problems at hand. On June 15th, seven major health insurance companies – two of which are represented here today – voluntarily agreed to stop marketing one type of Medicare Advantage plan, Private Fee for Service Plans, in response to complaints about deceptive sales practices, includingforged signatures and the enrollment of dead people. Today we will explore how CMS and the insurance industry reached the pointwhere they had to call a moratorium on marketing the Private Fee for Service Medicare Advantage Plans. We will also hear about the real life consequences of fraudulent marketing practices. Unfortunately, many seniors are coaxed into plans that don’t adequately meet their health care needs. They don’t understand that if they sign up for aMedicare Advantage plan, they no longer have the benefits of traditional Medicare coverage. In some instances, the private fee for service plans being sold to these individuals result in reduced coverage and higher out-of-pocket expenses that seniors on a fixed income can not afford. What most people know about the Medicare Prescription Drug Improvement and Modernization Act of 2003 (“MMA”), is that it created “Part D” of Medicare and launched Prescription Drug Plans run by insurance companies. But what MMA also did was boost the payments to the insurance companies operating managed care alternatives to traditional Medicare, and call the private plans “Medicare Advantage.” Before MMA, the government was paying these private plans 95% of the cost of traditional Medicare. Now, we are paying them 112% to 119% more. “Medicare Advantage” is aptly named — it is richly funded to out-compete traditional Medicare. 1
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The launching of “Part D,” in combination with the boost in payments to “Medicare Advantage” plans has resulted in a dizzying array of choices for seniors and disabled persons. In Houghton, Michigan, one of the small towns in my district in the Upper Peninsula, Medicare beneficiaries have 54 Prescription Drug Plans to choose from plus 14 Medicare Advantage plans. And that is nothing compared to other parts of the country. For instance, in Miami, there are at least 57 Prescription Drug Plans and 55 Medicare Advantage plans available. A May 2006 report by AARP documented the problems faced by seniors sorting through this maze, showing widespread confusion and even anxiety over the new Medicare Advantage and prescription drug plans. At what point does consumer “choice” become meaningless? When seniors and their families sit down at the kitchen table to figure out what health care insurance grandma and grandpa need, they should not have to hire an accountant to help them make the right decision Now we have a glut of private plans that end up dispatching fleets of sales agentsracing each other to get to the local retirement community, assisted living facility, or senior center first. We have telemarketers and insurance agents competing for commissions, prizes, and trips to Las Vegas based on who sold the most policies in theshortest time. These abusive sales practices under Medicare Advantage are very similarto the rampant sales problems witnessed with the launch of Medigap insurance in the1980s. The regulatory model which eliminated Medigap sales fraud should be applied to Medicare Advantage. As with the Medigap plans, plans should be standardized, statesshould be able to regulate Medicare Advantage companies and agents, and insurers should be held accountable for their agents’ actions. Our first panel will explore the extent of the problem and the consequences of deceptive sales. We will hear first from David Lipschutz, a staff attorney for CaliforniaHealth Advocates. California has had a lengthy experience with government managed care programs, and has often served the role of “canary in the coal mine.” We are especially grateful today for the testimony of three victims of predatory sales practices. Ms. Barbara Clegg-Boodram, a resident of Judiciary House in Washington, DC, home to a large number of seniors and disabled persons a few blocks from here, will testify on behalf of her fellow residents, Edith Williams, Mary Royal, and Grady Hammonds. Ms. Williams, Ms. Royal, and Mr. Hammonds were victimized by an agent who failed to properly explain the consequences of their enrollment in Medicare Advantage plans. Next we will hear from Kathleen Healey, the Director of the Alabama State Health Insurance Assistance Program (SHIP). SHIP is a national program in each state that offers one-on-one free counseling and assistance to people on Medicare. Also on this first panel is Mr. Lee Harrell, Deputy Commissioner of the Mississippi Insurance Department. Mr. Harrell will share with us some of the practical problems state regulators face when they investigate deceptive practices under the current structure.
University of Pittsburgh Medical Center said it would open at least 25 cancer clinics in Europe, Asia and the Middle East in the next decade, with help from General Electric Co.
Cancer care "is a growing market, growing at a very fast pace," said Reinaldo Garcia, the international head of GE Healthcare. The partners say there are an estimated 10 million new cancer cases a year globally, affecting both developed and developing countries.
Originally posted by justyc
Originally posted by ThePowerOfOne
I think R~~ gave us his first name...in his latest update.
huh? care to elaborate?
Behravesh's projection of $100 billion to $200 billion in costs dwarfs the $25 billion industry bailout plan that will be debated in Congress next week to prop up Detroit-based GM, Ford Motor Co. and Chrysler LLC. The drain on taxpayers from a rescue or a GM failure is a central issue for U.S. lawmakers.
CAPE CANAVERAL, Fla. – Space shuttle Endeavour raced toward the international space station on Saturday for a home makeover job after a brilliant moonlit launch that had NASA managers in awe.
The shuttle and its seven astronauts blasted into orbit Friday night on a mission to redo the insides of the space station, adding some extra bedrooms and a spare bathroom and kitchenette.
...
NASA almost delayed the launch because of a door frame left loose at the pad by a worker who promptly admitted his mistake. Launch controllers determined the flapping frame would not hit the shuttle.
A nearly full moon, glowing orange at times, adorned the sky as Endeavour began its journey.
Soon after liftoff, Mission Control informed the astronauts that a quick look at the launch pictures revealed two pieces of debris trailing Endeavour, one at 33 seconds after liftoff and the other around the two-minute mark. It did not appear that the debris hit the shuttle, but analyses will continue for several more days to be certain the spacecraft was not damaged.
Originally posted by yellowstone
Working on a dedicated. enterprisecorrupted.com...
[edit on 15-11-2008 by yellowstone]