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Seven of the largest health insurers offering private fee-for-service Medicare Advantage plans have entered into a voluntary agreement to suspend marketing of the plans amid allegations of illegal and aggressive sales practices, CMS officials announced on Friday.

Such practices have included the enrollment of dead or mentally incompetent Medicare beneficiaries, the impersonation of Medicare representatives and the use of personal information stolen from federal records, according to a Senate investigation released prior to a committee hearing in May (California Healthline, 5/16).

a.. Informing beneficiaries that the plans do not guarantee a physician will accept them as a patient; b.. Requiring sales agents to pass written examinations testing knowledge of MA plan details; c.. Calling prospective beneficiaries to ensure they understand fully how their MA plan will work; d.. Working with physicians and other providers to increase understanding of how the plans function (Lee, Washington Post, 6/16); e.. Providing CMS with a list of all sales agents and authorizing CMS to share the list with state insurance departments if necessary; and f.. Including "delegated" brokers and agents, as well as those sponsored by the plan, on lists of planned sales events provided to CMS.

Under the agreement, insurers will be able to enroll members during the suspension (Reichard, CQ HealthBeat, 6/15).

The agreement does not affect ongoing criminal investigations, according to Abby Block, director of the agency's Center for Beneficiary Choices (Washington Post, 6/16).

Insurers participating in the suspension are Humana, UnitedHealth Group, Wellcare Health Plans, Universal American Financial, Coventry Health Care, BlueCross BlueShield of Tennessee and Sterling Life Insurance, according to a statement from CMS (Bloomberg/New York Times, 6/16).

Comments Block said, "This voluntary agreement demonstrates the plans are stepping up

to assure deceptive marketing practices end and beneficiaries fully understand what they are purchasing" (Colliver, San Francisco Chronicle, 6/16). Block added that the alleged unethical sales tactics were committed by a relatively small number of "rogue sales agents" rather than the companies themselves.

Karen Ignagni, president of America's Health Insurance Plans, said the insurance industry is "moving immediately" to put additional safeguards in place against unethical marketing, including the development of a uniform reporting mechanism to identify agents selling on behalf of MA plans and "clear guidelines for health plans to report serious broker-agent misconduct

to CMS and the states."

Senate Finance Committee Chair Max Baucus (D-Mont.) said, "I applaud plans for volunteering a suspension," adding, "I'd like to see CMS spend less time

promoting private coverage and more time figuring out how to regulate the actions of insurers who sell directly to seniors."

House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) said, "The administration's response is to allow private companies to determine which crimes they'll plead to and which sentences they'll serve. This will do virtually nothing to protect Medicare beneficiaries and is a pathetic attempt to pre-empt congressional action" (CQ HealthBeat, 6/15).

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