Medicare’s Open Enrollment Is Open Season for Scammers

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Yves here. I hate to go so heavy on Medicare open enrollment. But some readers have thanked us for making this topic a priority and have said that it has helped them make much better decisions about Medicare options.

if you are so fortunate not to be directly or indirectly exposed, open season on seniors continues through December 7. And for those of you who have had to deal with Obamacare plan selection, you ain’t seen nuthin’ yet.

While my anecdata is far from perfect, this year, it seems pretty certain that the Medicare Advantage plan hucksters are spending even more on air time than the prior two years when I’ve had the misfortune to be in the room with a TV during commercial breaks. And not only is the shilling as bad as for Thighmasters, weight loss programs, and ambulance chasing law firms, but the pitches are flatly dishonest. Even the horrible and almost as frequent drug ads at least have the narrator quickly reciting what is often a horrorshow level of side effects. Here, there’s clearly no requirement to make full disclosure. For instance, the Medicare Advantage shills often talk about prescriptions being “covered,” when anyone who had signed up for health insurance recently knows if they are taking any pricey meds, they need to check if their medication is covered, because odds are decent it won’t be.

This article discusses another level of abuse: of phone reps who lie to consumers and even enroll them in plans without their consent. These practices have become so common that CMS now allows Medicare enrollees a window to back out of plans that have been misrepresented.

Oh, and one of the TV ads described as deceptive in this article sounds exactly like the promotions running nonstop here. And notice how the scammers are even able to spoof Medicare and local hospital numbers as their caller IDs. Beware!

By Susan Jaffee. Originally published at Kaiser Health News

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix.

Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or include their doctors. In response, the Centers for Medicare & Medicaid Services has threatened to penalize private insurance companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.

The agency has also revised rules making it easier for beneficiaries to escape plans they didn’t sign up for or enrolled in only to discover promised benefits didn’t exist or they couldn’t see their providers.

The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. 15 and runs through Dec. 7. A common trap begins with a phone call like the one Linda Heimer, an Iowa resident, received in October. She won’t answer the phone unless her caller ID displays a number she recognizes, but this call showed the number of the hospital where her doctor works.

The person on the phone said she needed Heimer’s Medicare number to make sure it was correct for the new card she would receive. When Heimer hesitated, the woman said, “We’re not asking for a Social Security number or bank numbers or anything like that. This is OK.”

“I can’t believe this, but I gave her my card number,” said Heimer. Then the caller asked questions about her medical history and offered to send her a saliva test “absolutely free.” That’s when Heimer became suspicious and hung up. She contacted the 1-800-MEDICARE helpline to get a new Medicare number and called the AARP Fraud Watch Network Helpline and the Federal Trade Commission.

But later that morning the phone rang again and this time the caller ID displayed a number matching the toll-free Medicare helpline. When she answered, she recognized the voice of the same woman.

“You’re not from Medicare,” Heimer told her.

“Yes, yes, yes, we are,” the woman insisted. Heimer hung up again.

It’s been only two weeks since Heimer disclosed her Medicare number to a stranger and, so far, nothing’s gone wrong. But armed with that number, scammers could bill Medicare for services and medical supplies that beneficiaries never receive, and the scammers could sign seniors up for a Medicare Advantage or drug plan without their knowledge.

In California, reports of deceptive sales practices for Medicare Advantage and drug plans have been the top complaints to the state Senior Medicare Patrol for the past two years, said Sandy Morales, a case manager for the group. The patrol is a federally funded program that helps seniors untangle insurance problems.

Nationwide, the Senior Medical Patrol has sent 74% more cases in the first nine months of this year than in all of 2020 to CMS and the Health and Human Services Inspector General for investigation, said Rebecca Kinney, director of the Administration for Community Living’s Office of Healthcare Information and Counseling at HHS, which oversees the patrols. She expects more complaints to come in during Medicare’s open-enrollment period.

And last month, CMS officials warned the private insurance companies selling Medicare Advantage and drug plans that federal requirements prohibit deceptive sales practices.

Kathryn Coleman, director of CMS’ Medicare Drug and Health Plan Contract Administration Group, said in a memo to insurers that the agency is concerned about ads widely promoting Advantage plan benefits that are available only in a limited area or to a restricted number of beneficiaries. CMS has also received complaints about sales information that could be construed as coming from the government and pressure tactics to get seniors to enroll, she noted.

Coleman reminded the companies they are “accountable and responsible for their marketing materials and activities, including marketing completed on a MA plan’s behalf” by sales representatives. Companies that violate federal marketing rules can be fined and/or face enrollment suspensions. But a CMS spokesperson could not provide examples of recent violators or their penalties.

If beneficiaries discover a problem before March 31, the date the three-month disenrollment period ends each year, they have one chance to switch to another plan or to original Medicare. (Those who choose the latter may be unable to buy supplemental or Medigap insurance, with rare exceptions, in all but four states: Connecticut, Maine, Massachusetts and New York.) After March, they are generally locked into their Advantage or drug plans for the entire year unless they’re eligible for one of the rare exceptions to the rule.

CMS this year spelled out another remedy for the first time.

Officials can grant a “special enrollment period” for people who want to leave their plan because of deceptive sales tactics. These include “situations in which a beneficiary provides a verbal or written allegation that his or her enrollment in a MA or Part D plan was based upon misleading or incorrect information … [or] where a beneficiary states that he or she was enrolled into a plan without his or her knowledge,” according to the Medicare Managed Care Manual.

“This is a really important safety valve for beneficiaries that clearly goes beyond just the limited opportunity to switch plans when someone feels buyer’s remorse,” said David Lipschutz, associate director of the Center for Medicare Advocacy. To use the new option, beneficiaries should contact their state’s health insurance assistance program at www.shiphelp.org/.

The option to leave is also available if a significant number of plan members are unable to access the doctors or hospitals that were supposed to be in the provider network.

Nonetheless, the scams continue around the country, experts say.

A misleading television commercial in the San Francisco area has enticed seniors with a host of new benefits including dental, vision, transportation benefits and even “money back into your Social Security account,” said Morales. Beneficiaries have told her group that when they called for information they were “erroneously enrolled into a plan that they never gave permission to enroll into,” she said.

In August, an Ohio senior received a call from someone telling him Medicare was issuing new cards because of the covid-19 pandemic. When he wouldn’t provide his Medicare number, the caller became angry and the beneficiary felt threatened, said Chris Reeg, director of the Ohio Senior Health Insurance Information Program.

Reeg said another senior received a call from a salesperson with bad news: She wasn’t getting all the benefits from Medicare she was entitled to. The beneficiary provided her Medicare number and other information but didn’t realize the caller was enrolling her in a Medicare Advantage plan. She found out when she visited her doctor, who did not accept her new insurance.

In western New York, the culprit is an official-looking postcard, said Beth Nelson, the state’s Senior Medicare Patrol director. “Our records indicate … you may be eligible to receive additional benefits,” it says, enticingly. When Nelson’s client called the number on the card in September for more details, she provided her Medicare number and later ended up in a Medicare Advantage plan without her consent.

Heimer’s scammer was persistent. When the stranger tried to reach her a third time, Heimer said, the caller ID displayed the phone number of another local hospital. She told the woman she had reported the calls to CMS, the AARP Fraud Watch Network Helpline and the FTC. That finally did the trick — the woman abruptly hung up.

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49 comments

  1. Arizona Slim

    Yours Truly just turned 64. I’m already getting pummeled by Medicare Disadvantage mailings and lemme tell you, my paper shredder has been eating well.

    On the telephonic front, I’m getting a flurry of calls coming from numbers I don’t recognize. I just let ’em go to voice mail, and…

    …no messages left.

    The good news is that I’m a pretty healthy little Slim, so I have that in my favor. I also have a finely tuned BS detector, thanks to Naked Capitalism.

    If you haven’t done so already, drop a donation on Yves and the gang. They deserve it!

    Reply
  2. Pat K California

    I am truly lucky to have had a Dad who was a Medicare Ship Counselor for years. Once I turned 64, every visit home involved long sessions at the kitchen table where he taught me the Medicare ropes … and dropped all the pearls of wisdom he had soaked up over the years. The thing I remember the most was that he personally wouldn’t touch a Medicare Advantage Plan with any length of pole. He was traditional Medicare all the way … as am I now.

    My Dad passed away last spring. But his knowledge lives on as I am now in charge of my mother’s Medicare as well as my own. In fact, I just finished analyzing the available Medicare Drug Plans for both of us. I do this with zeal and glee every year so that neither one of us gives the private health insurance industry a cent more than we can comfortably get away with! Thank you so much, Dad …

    Reply
      1. flora

        adding: the above link offers comparisons of all the Medicare plans including (fake)Advantage Plans, traditional Medigap plans, etc.

        The traditional Medicare Part D drug plan is the plan my friends are most likely to change every year, depending on what new meds they may be on, or because the change in co-pays for their current meds has become too expensive in their current Part D plan. They look for a new Part D plan to enroll in with lower co-pays for the meds they take.

        Imo, by the time some of my friends are in their mid-80’s they need younger help to wade through this sometimes very confusing information gathering process. Every year it gets harder to find this information, even when you know it’s there. I have to wonder if this is by design.

        Reply
        1. Katiebird

          And I found (after this year’s evaluation of Part D plans) that I’ll have to get 2 of my prescriptions using goodRX because No Plan covers 2 pretty expensive drugs. And I just remembered I have to look them up on GoodRX — I might not be taking them next year at all.

          Reply
        2. Maggie

          Flora – On the first page of your link I am asked to select from 4 choices. Can you give me (in just a few words) the difference between looking at Part D plus Medigap Plans and looking at Part D alone? Thanks again for helping this newbie… Maggie

          Reply
          1. flora

            Insurance companies that sell traditional Medicare policies generally offer both a traditional medigap policy and a separate Part D drug policy (covers drug costs only). So, you can buy a medigap policy from one insurer and a Part D drug policy from a different insurer.
            Or, you can buy an “all in one” medigap + part D drug policy from one insurer. Sometimes the all in one policies have a higher drug cost component than buying the medigap policy alone and buying a stand alone Part D policy alone from another insurer would cost. I know several people who have a medgap plan from one insurer and a Part D plan from a different insurer because that works for them. Costs, medical needs, fixed drug needs, etc.

            Hmmm, this is already well past a few words… Much shorter:

            the Drug Plan (Part D) option lists only the stand alone Part D drug plan offerings

            the Drug Plan & Medigap option lists only the “all in one” offerings.

            the Medigap only option list only the traditional Medigap plans without the Part D included.

            Reply
          2. juno mas

            Maggie:

            Whatever Plan you choose, learn about the Part D (drug plan) penalty. Believe it or not, there is a penalty for NOT enrolling in Part D plan of an appropriate source. The dollar penalty is based on the amount of time you are not covered by a qualified plan. The penalty may seem small, but it is applied to every monthly premium, from then on…and on…and on, year after year.

            (I pay the penalty because the Medicare insurance exchange I’m required to use did not enroll me properly one year. Be ready to read endlessly about Medicare insurance plans!)

            Reply
            1. Bridget

              My husband has two very cheap generic prescriptions, which he currently purchases with GoodRx discounts for something like $5 a pop. So, he doesn’t currently use his Part D plan, although he has one in order to avoid the annual penalty for late enrollment should he ever require pricier drugs and finds that a Part D plan would be beneficial. (Part D plans can be switched annually.)
              Since he doesn’t expect to use the benefits, he enrolls every year in the cheapest, worst, Part D plan that is available. Usually at a cost of $12-$15 per month. Wellcare and Silverscript generally have some bottom of the barrel plans to choose from. The plans are so bad that it’s cheaper for him to pay for his current scripts himself, but it’s “insurance” to maintain his eligibility to switch to better (and pricier) plans in the future, penalty free.

              Reply
            2. Maggie

              Thanks so much Flora and Juno Mas. I think I said this before.. both over 65.. currently employed with Corporate UHC medical coverage. Plan is he retires 7/1/22. Corporation offers a “subsidized” dis-Advantage Plan..I’m saying “no thank you” based on what I read here at Naked Capitalism. So another thing to learn about –> “Part D penalty” …oh my!

              Reply
              1. flora

                Have him check with his HR to learn if they will furnish a “creditable drug coverage” certificate/letter for both you and him at time of his retirement. They should do assuming his/your health coverage while he’s been employed included prescription drug coverage. Really encourage him/you to contact his HR office prior to retirement to get this info, and ‘a drug coverage’ letter or verification during his employment. You cannot start too soon to check and verify these things. Start now. (We make some fun of HR offices here at NC, but a good HR department is invaluable for this sort of information. imo.)

                Reply
                1. flora

                  adding, not about part D but general medigap plans: If you were age 65 before Jan 1st, 2020, then you were then and are now eligible for medigap plans like Plan C contingent on age at time X stuff. Check the wording of “eligible for at or by date X” verbage. My 2 cents.

                  Reply
                  1. Maggie

                    Pearls of Wisdom for sure Flora… checking those dates… yes both 65 as of 1/1/2020. In a few words what is my potential benefit with eligibility for Medigap Plan C “contingent…”?

                    Reply
                2. Maggie

                  I checked with the HR dept. The form you are referring to (creditable coverage – medical and drugs) is Medicare CMS form. The information I am receiving …the form can not be completed by HR until the actual first day of retirement… And yes, it is our responsibility to obtain the form, actually 2 forms one for each of us…. from Medicare and for us to submit it to the Corporate HR Dept… Wow… I agree, I need to start figuring all this out now!!!!

                  Reply
            3. Arizona Slim

              Wait a minute. I don’t take prescription drugs. None. Zip. Nada.

              I still have to sign up for this insurance, even though I haven’t take a drug in YEARS?

              Reply
                1. Oh

                  Several years ago a friend wanted to switch from Disadvantage to traditional Medicare and she called Medicare. The person she talked to was very pro traditional Medicare and she explained the requirement for Part D drug coverage and Medicap policies. She found out that she had to pay the premium for Part A as well as for Medicap and Part D drug coverage. The total premium for these was quite a bit more than the Disadvantage Plan which also included a gym membership (around $50 per month for her). She didn’t switch because she’s quite healthy and wanted to minimize her insurance $ paid per month. You can see how the govt. and the insurance crooks worked hand in glove to rig the prices and confuse people with benefits (or lack thereof). Ever since the Disadvantage plans were allowed in and the drug plans were introduced (thank you George Bush and Billy Tauzin et al) Medicare has been sold to the Insurance and Pharma crooks.

                  Reply
              1. Pat K California

                Huh. I’ve never looked at drug plans for people who didn’t take drugs. So I tried it at Medicare.gov just to see what would happen.

                Using a random Arizona zip code, your cheapest plan might be something like Aetna SilverScript SmartRx (PDP). Monthly premium: $7.50. As long as you don’t order any drugs, that’s all the plan costs … $90.00 per year. Of course, you have to do your OWN research! I had to use assumptions that may not be correct for you.

                But thanks for the opportunity to learn something new. Appreciate it!

                Reply
                1. juno mas

                  The super-low premium Part D plans allow you to get certain drugs at no cost. (You have to look in the particular plans formulary). The formulary describes what are called Tier 1 and Tier 2 drugs. Tier 1 drugs (usually generics) are offered at no cost, IF you use “in Network” pharmacies.

                  On the Medicare website you can search for pharmacies near where you live. It will tell you if they are in Network or Retail. Get familiar with the Medicare.gov site; you’ll be using it a lot.

                  Reply
                  1. flora

                    Yep. If you only listen to the TV ads for Medicare Advantage [sic] plans you’ll hear the phrase “It’s EASY” many times. EASY vs. the work to find out what plans are offered and what they include. That “EASY” could cost you a lot in the long run, imo. If it sounds too good to be true. / ;)

                    Reply
              2. flora

                Yes. If you take no meds on a regular basis, then find the cheapest Part D plan you can find. It will save you the penalty cost going forward, and the penalty cost when you think you need a Part D plan can be substantial over time, like a parking ticket unpaid. Like interest payments, it accrues. (Yes, it’s mostly a tax, but even so…self protection, etc….)

                Reply
            4. Oh

              The penalty for not enrolling in a drug plan is another legislation written by the druglords and passed by the CONgress which works for them. Why should there be a penalty at all? Insurance is supposed to be voluntary. %4#@!

              Reply
        3. antidlc

          It’s ridiculous, isn’t it, Flora? We have to go “shopping” each year.

          We only know what drugs we may be taking, when we sign up. We don’t know what drugs we may need in the upcoming year.

          I could just scream. The time tax is unbelievable.

          Reply
    1. Pat K California

      Quick tip for everybody! The Medicare.gov site is a great place to get started when you’re looking for plans. But remember one thing when looking at drug plans: the information at Medicare.gov is 6 months old (the insurance companies have to submit their data to Medicare by this date for the following year). Worse, the insurance companies are not held to what you see on Medicare.gov, although the good ones usually do. So it is imperative, once you’ve narrowed your search, to go directly to the insurance company websites to double check the data.

      EVEN THEN the insurance companies can change rates, formularies, etc. after you’ve signed on! What a system, eh?

      Reply
  3. ambrit

    I jokingly mentioned to Phyl that the local community college should offer a free Senior Indoctrination Program of courses in navigating both the Medicare and Social Security systems. Home Ec for Geezers.
    Her reply: “That would cut off too many revenue streams for the Oligarchs.”
    Thus, I can well understand the “new” “University of Austin” based “Public University” scheme.
    Education is ripe for the introduction of “Parrallel Institutions.”
    See: https://www.huffpost.com/entry/home-ec-classes_n_5882830
    Also, speaking of parrallel institutions: https://www.home-ec101.com/
    Stay safe! (Winter is coming.)

    Reply
  4. Pat

    I am fairly new to Medicare and because of my birthday, the new enrollment period AND the open enrollment period has meant that 2021 has been a constant barrage of mailers and phone calls. Since I have access to a very reputable healthcare advocate service I have the advantage of knowing to ignore it all. Mostly.

    I say mostly because those deceptive mailers aren’t just in Western NY, but also NYC. I did open it and for a moment was fooled. I don’t remember the detail that made me hesitate and then reject it as just more advantage bs. Yet I am not sure if I had not just gone through the whole set up and dealing with real Medicare paperwork I would have known. I can only hope that as I get older, my long habit of not clicking through or phoning numbers but going back to the source may mean I don’t get taken.

    So much of our culture is about scams anymore.

    Reverse mortgages anyone?

    Reply
    1. Arizona Slim

      I had a friend who got a reverse mortgage from Wells Fargo. When she signed the paperwork, she was NOT of sound mind, but that made no difference to the bank. She wound up losing her house.

      Reply
      1. Oh

        My friend got a reverse mortgage and I asked him if he’d checked out thorougly and he said his financial advisor had recommended the company to him. Huh? I consider most financial advisors to be brokers who get a commission for each every transaction.

        Reply
  5. flora

    Rules of thumb to avoid Advantage [sic] plans:

    Mailings for “new Medicare enrollment!” go in the trash.

    Phone calls with the word “insurance” or “Medicare” or “advisor” in the opening pitch are quickly cut off and hung up on.

    Reply
  6. diptherio

    Let me get this straight – CMS knows that these scams are so widespread that they’ve changed their rules to account for all the people getting taken by them…but they can’t name a single company that’s even been fined for this malfeasance.

    If I didn’t know any better, I’d think that CMS was purposefully enabling this criminality…

    Reply
    1. juno mas

      Well, search Wikipedia for “Seema Verma” and you’ll learn the CMS administrators (Grifter in Verma’s case) are appointed by the President. Verma by Trump. CMS has authority over medical insurance providers, as well as Medicare and Medicaid.

      Reply
      1. Left in Wisconsin

        Ugh, this seems gratuitous. There is a big difference between systems intentionally designed to make your life difficult or allow you to be screwed by private scammers and the public employees forced to manage them, who are often good-hearted, know the flaws and pitfalls inside out and are dying to help you if you can ever get through to them, and have to bear the brunt of the justified anger many of us feel when having to confront the system.

        Good government is possible. We had it here in Wisco when I moved here in the 1980s, and I know this because it was amazing compared to what I was used to in NY state. We should all expect it. We unfortunately cannot count on having it.

        Reply
        1. Discouraged in WI

          Wisconsin has two good things. When we went on Medicare, the County Health advisor presented a program about it the at the local library. Then, you could go to a separate program at the County Health Department, after which you could make an appointment for the advisor to review your actual situation. The advisor was so helpful-spent about an hour with me, and even called medicare to check on the specific injection my husband was/is taking. I told her that if people actually knew she did this there would be a line around the block.

          Second, Wisconsin has Senior Care, a plan that provides qualified drug coverage, for $30/year. Since my husband’s injection is done at the hospital clinic, it is covered by part B, and Senior Care takes care of being in a qualified plan if he should even need greater coverage. (We do not qualify for any payments by Senior Care, just have the coverage.)

          Reply
          1. juno mas

            These are important points that are being made about Wisconsin. Every State administers/impacts how Medicare is offered/regulated in the marketplace. Where you live (County by County) in a State also affects which Medicare “gap” plans are offered in State.

            Something to think about if you ever relocate. (Including ex-patriation; Medicare is not offered on foreign soil.)

            Reply
  7. Timothy Dutra, MD, PhD

    Thank you, Yves. I’m applying for SS and Medicare now (a little late because I still work full-time). Even though I’m a Physician (Forensic Pathologist), I am dazed and confused by Medicare, Medigap, and Medicare Advantage plans and scams. This article, by Susan Jaffee, and the one yesterday, by Harris Meyer, both originally published in Kaiser Health News, have lifted the fog and allowed me to see truth. I feel empowered, and able to make educated decisions about my future healthcare. I’d still rather have public option, i.e. socialized, healthcare for all, but at least I’m no longer an obligate victim of our sick system.

    Reply
  8. Lee

    I am happy to report that my post about this post is getting a lot of positive play over at Daily Kos.

    I regularly do this sort of thing, often with mixed result, as one might reasonably expect from a certain element that tend to dominate that site. Often, my pleasure is confined to annoying them. This time is an exception.

    Reply
  9. antidlc

    https://www.dallasnews.com/business/health-care/2021/11/09/more-plans-less-money-why-many-seniors-are-choosing-medicare-advantage/

    More plans, less money: Why many seniors are choosing Medicare Advantage

    Over 26 million people nationwide chose Advantage plans this year, more than twice as many as a decade ago, according to the Kaiser Family Foundation. In the same time, Advantage plans’ market share grew from 25% to 42%, and Advantage is projected to have more customers than traditional Medicare by 2030.

    In Dallas County, nearly 45% of Medicare beneficiaries — about 146,000 older residents — enrolled in Advantage plans this year, Kaiser reported. In Tarrant County, the penetration is nearly half, and in El Paso, it’s over 63%.

    Why are these plans gaining such a following?

    “It definitely seems to be a combination of factors — zero premiums, extra benefits and all the marketing,” said Meredith Freed, a policy analyst with Kaiser Family Foundation’s program on Medicare. “And a lotta people are coming from employer coverage with an HMO or PPO. So there’s some familiarity with that kind of system.”

    Reply
    1. juno mas

      Most Medicare Advantage plans require you to get permission to see a medical specialist (Oncology, Cardiology, etc.) Specialists that those 65+ are likely to need. It’s the HMO/PPO general practitioner (Doctor) that will make that determination (on their own sweet time & inclination). Many of the “extra benefits” (vision/hearing/dental) are provided at a similar discount by simply joining AARP.

      Medicare Advantage plans require YOU to be clairvoyant and take the risk of unforeseeable medical events.

      As I’ve said before: Advantage plans are price attractive, but place all the financial risks of old age on you! (I know, you’re different.)

      Reply
  10. Rod

    Being in a union from teenager until retirement gave me the opportunity to purchase my supplemental insurance plan from the union trust fund upon retirement and also I stayed with traditional medicare. The supplemental plan covers 80% of the remaining 20% that medicare doesn’t pay. It also covers eye, prescriptions and dental. Covers the rest of the family at 80% with a 3500 maximum out of pocket per year per individual and 10 thousand maximum out of pocket per year per family then all coverage is at 100%. Prescriptions are covered at 100% if mail order is used. Small deductibles on prescriptions if local pharmacy’s are used. Doctor visits are 25 dollars out of pocket per visit but once it hits 10 visits then 100% paid. These are not bankruptcy causing medical charges and it cost me 450 a month for the plan.
    They would have to claw my medical plan out of my cold dead fingers before I would give it up. Which someday unfortunately they will.

    Reply
  11. Greg S

    Got this in my email today. Have any of you heard of the following? Looks like they may be after even us traditional medicare types:

    November 11, 2021

    Dear single-payer supporter,

    Thank you for adding your name to the petition to stop the stealth privatization of Medicare through the Direct Contracting Program. Along with a group of PNHP leaders, I will travel to Washington, D.C. on Tuesday, Nov. 30 to hold a press event and deliver the petitions to Health and Human Services Secretary Xavier Becerra. We will demand that Congress hold hearings on the DC program, and the Biden Administration end the pilot on Dec.31, 2021.

    We need to collect as many signatures as possible before Nov. 30. Please share the petition with your colleagues and ask them to sign on.
    Share our petition

    Here’s a sample email to colleagues to get you started:

    Dear [colleague],

    I recently learned about a stealth plan to privatize Traditional Medicare through a Trump Administration pilot program called Direct Contracting (DC). Under the DC program, nearly 30 million Medicare beneficiaries could be auto-assigned into third-party Direct Contracting Entities (DCEs) owned by commercial insurers, venture capital investors, and for-profit hospital chains, without beneficiaries’ understanding or consent.

    Instead of paying providers directly, Medicare gives DCEs risk-based capitation payments, allowing them to pocket what they don’t pay for in care. This payment model provides a strong incentive for DCEs to increase capitation payments through fraudulent “upcoding” of diagnoses, and to increase profits by restricting care. Researchers estimate that DCEs may spend as little as 60% of revenues on patient care.

    If left unchecked, DCEs could essentially privatize Medicare in the very near future, without a vote by Congress.

    Please join me in adding your name to this petition to stop the DC program and protect Medicare for future generations.

    https://pnhp.org/DCEPetition

    For more details about the DC program, read this one-page fact sheet from Physicians for a National Health Program, and watch this short video by Dr. Ana Malinow.

    And a sample social media post:

    [ideal for Twitter and Facebook]

    Left unchecked, the Trump-era Direct Contracting program could hand *all of* traditional Medicare to Wall St.

    We must act now to stop this program and save Medicare for future generations! Please sign our petition, which will be delivered on 11/30.

    https://pnhp.org/DCEPetition

    Every name increases our chances of stopping this program in its tracks. Please share our petition today.

    In solidarity,

    Susan Rogers, M.D.
    President

    Physicians for a National Health Program
    29 E Madison St Ste 1412 | Chicago, Illinois 60602
    312-782-6006 | info@pnhp.org

    Reply
    1. Telee

      These direct contracting plans are coming from The Center of Medicare and Medicaid Innovation Center. The director of the center, Liz Fowler, was appointed by the Biden administration. This is the same Liz Fowler who came from the pharmaceutical industry to the Max Baucus committee and who was primarily involved with writing and implementing the ACA. After the ACA she went to work for Johnson and Johnson as a director of their global health policy. Then she was appointed by Obama as special assistant for healthcare and economic policy at the National Economic Council. Now Biden has put the fox in the henhouse where she is developing plans to completely privatize Medicare as Dr. Susan Rogers points out.
      I’ve written about this earlier in comments at NC but saw no response indicating interest by readers of NC. Hopefully, this attempt to privatize Medicare and Medicaid will elicit the response it deserves.

      Reply

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