[Congressional Record (Bound Edition), Volume 153 (2007), Part 27]
[Extensions of Remarks]
[Page 36450]
[From the U.S. Government Publishing Office, www.gpo.gov]




   ACCOUNTABILITY AND TRANSPARENCY IN MEDICARE MARKETING ACT OF 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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