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--- Begin Message ---Asclepios Your Weekly Medicare Consumer Advocacy Update Get Real March 13, 2008 • Volume 8, Issue 11 When the public demands action that threatens powerful interests, one of the oldest tricks used by Washington power brokers is to take some action—pass a law, enact a regulation, pledge to abide by new voluntary rules—that appears to address the problem but is, in reality, completely ineffective. The goal is to fool the public and the press and head off any efforts at real reform. Case in point: Stopping the aggressive, deceptive and fraudulent marketing of Medicare private health plans. Pressure is building to enact legislation that would curb these abusive practices. Senator Herb Kohl, Democrat of Wisconsin, and Senator Ron Wyden, Democrat of Oregon, have a bill that would allow state insurance departments to enforce tough new marketing rules. It would clean up the current legal mess that allows states to chase individual agents that deceive consumers but prevent states from taking action against the insurance companies that employ these agents. The legislation is modeled after Congress' success in cleaning up the market for Medigap supplemental plans, which standardized plan benefits and curbed abusive marketing. Insurance companies want to keep the states out of their hair. So last week, their lobby, America's Health Insurance Plans, issued a call for "more stringent federal standards." A close inspection reveals that these "more stringent" rules are either already in place or riddled with loopholes. AHIP proposes a ban on door-to-door marketing, which is already against federal guidelines. AHIP wants to talk about regulating broker commissions to discourage agents from moving clients from plan to plan each year in order to win new commissions. But the group says nothing about prohibiting volume bonuses and other incentives that encourage mass enrollments that fail to account for the individual needs of consumers. The insurance industry should not be dictating the rules that govern their marketing conduct. It is up to Congress to establish tough rules and allow states to enforce them. Please urge your senator to cosponsor S. 1883, the Accountability and Transparency in Medicare Marketing Act of 2007 (http://www.kintera.org/TR.asp?a=beJLIYNyFbJIJ2K&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE). Medical Record "I am employed by a nonprofit agency functioning as a care manager working with low-income elderly and disabled clients in public housing. My clients are subjected to fraudulent marketing practices by virtually all the insurance companies. They are subjected to 'cold call' visits to their residences, repeated and often rude, harassing calls to their homes and bombarded with mailings in an attempt to lure them into enrollment in Medicare Advantage Plans. Each company offers a new gimmick in an attempt to entice new enrollees. Most of my clients are on both Medicare and Medicaid, and already receive the 'perks' used as enticements. Clients feel angry, betrayed and embarrassed when they realize they have been victimized by the insurance company. Many times they are left without any medical coverage or prescriptions because they were enrolled in plans not accepted by their medical providers and plans not appropriate for the medications they depend on. Clients are literally placed in life-threatening situations because they are no longer getting the life-sustaining care they need. Emergency department visits can rise, quality of life decreases as clients are forced to wait until the disenrollment and appropriate plan reenrollment process is completed" (Story submitted to the Medicare Private Health Plan Monitoring Project (http://www.kintera.org/TR.asp?a=ehKRI7OKLeIPKcJ&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE), Medicare Rights Center, November 16, 2007). "...AHIP's proposals amount to endorsing the status quo regulatory scheme in which MA plans nationwide are regulated by one entity—CMS—that does not appear to have the capacity to provide adequate oversight. AHIP's proposal would preserve an unworkable system that divorces oversight of agents from oversight of the plans they work for, complicating the task of enforcing consumer protections" (Letter on Medicare Marketing to Senators Baucus and Grassley, Center for Medicare Advocacy, March 12, 2008). "'State insurance regulators have long-standing institutional knowledge, expertise and resources upon which to construct appropriate marketplace safeguards,' McRaith said. 'A return of state oversight authority over Medicare Advantage and prescription drug plans would allow us to better protect seniors from companies and agents engaged in unscrupulous or abusive sales practices'" ("State Insurance Regulator Testifies to Need for Greater Oversight of Medicare Marketplace (http://www.kintera.org/TR.asp?a=huIXJgPWKhLWImI&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE)," National Association of Insurance Commissioners, February 7, 2008). * * * * Medicare Part D Appeals Help for Advocates Is Here! MRC's new Medicare Part D Appeals: An advocate's manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources. Register for a FREE copy (http://www.kintera.org/TR.asp?a=anJJKVNuEaKJK2L&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE) of this great resource. * * * * Medicare Part D Monitoring Project The Medicare Rights Center (MRC) would like to hear about your experience, or that of someone you know, enrolled in a private health plan. With information about what the issues are with Medicare Advantage plans, we will be able to demand that those problems be fixed. Submit your story at www.medicarerights.org/maplanstories.html (http://www.kintera.org/TR.asp?a=dqLPK4OGKdJQIcK&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE). * * * * The Louder Our Voice, the Stronger Our Message Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today (http://www.kintera.org/TR.asp?a=jmK1JmM4IkJUJlL&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE). * * * * The Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States. Founded in 1989, MRC helps older adults and people with disabilities get high-quality, affordable health care. Visit our online subscription form to sign up for Asclepios at http://www.medicarerights.org/subscribeframeset.html (http://www.kintera.org/TR.asp?a=cpINK1NCKdIHL1K&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE). To unsubscribe from this mailing, please go to http://www.kintera.org/TR.asp?a=anKJIVMuHdLML2I&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE To modify your profile and subscription preferences, please click go to http://www.kintera.org/TR.asp?a=dqIPI4OGJgJTJcL&s=slK7IiORKdK0IdM0F&m=iqLMLYNBKbJYE
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