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US Health Insurance Firms Suspend Sales, Promise to End Fraudulent Practices

Seven key health insurance firms in US have agreed to stop selling a type of government-funded plan for the elderly in response to complaints that sales agents forged signatures and also adopted aggressive tactics, the Centers for Medicare and Medicaid Services said Wednesday.

The seven companies are working on new marketing guidelines with the U.S. Medicare health insurance program for the elderly and disabled.

Widespread reports of high-pressure and fraudulent sales techniques used by some independent salespeople hawking Medicare managed-care plans is leading to greater scrutiny of private companies that sell these products as an alternative to traditional Medicare.

The Senate Special Committee on Aging held a hearing in May to address complaints about what's known as private fee-for-service plans, the fastest- growing type of private Medicare managed-care plan.

These policies offer fewer restrictions on doctors and hospitals and often come with benefits that standard Medicare doesn't cover, such as dental or vision services. They differ from basic Medicare in that the entire benefit is managed by a private company.

Medicare Advantage plans sometimes carry lower monthly premiums than regular Medicare, although benefits may not be the same as those offered by the government insurance program.

Medicare has 43 million beneficiaries, of whom 7.5 million are in Medicare Advantage plans. Private fee-for-service plans are the fastest-growing part, with enrollment rising 72 percent to 1.3 members in February 2007 from July 2006.

The government spends 19% more on private fee-for-service Medicare Advantage plans than traditional Medicare and spends 12% more on all Medicare Advantage plans, according to the Medicare Payment Advisory Commission.

The senate panel heard testimony that health- insurance agents tricked elderly customers into buying Medicare Ad
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