Medicare Marketing Violations During the Enrollment Period: The New York StateWide Senior Action Council's "Medicare Fraud of the Month"

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New York StateWide Senior Action Council, Inc.

Nov 21, 2023, 14:00 ET

ALBANY, N.Y., Nov. 21, 2023 /PRNewswire/ -- The New York StateWide Senior Action Council (StateWide), an organization dedicated to advocacy for the rights of seniors in New York State, today announced its Medicare Fraud of the Month for November, Medicare Marketing Violations During the Medicare Enrollment Period from October 15 through December 7, 2023.

The StateWide Fraud of the Month is a component of the Senior Medicare Patrol (SMP), the definitive resource for New York State's senior citizens and caregivers to detect, prevent, and report healthcare fraud, errors, and abuse. StateWide is New York's grantee/administrator for this Federal Program.

"Medicare's annual enrollment period (AEP) is a time each year when individuals can change their Medicare and prescription drug selections. StateWide offers free confidential services by their MCCAP (Managed Care Consumer Assistance Program) certified outreach counselors to assist seniors in making the right decisions about their healthcare and prescription benefits," announced Maria Alvarez, Executive Director of StateWide.

She added, "During the AEP Medicare beneficiaries see ads from various insurance companies offering their plans for the upcoming year in the form of television commercials, mail, ads online, and more. Medicare Advantage Plans (Part C) and Part D, unlike Original Medicare, are managed and marketed by private insurance companies. Agents and brokers are bound by strict regulations when they engage in marketing activities."

Common marketing violations to look out for during this open enrollment include:

Being approached in public areas, such as a parking lot, hallways, or sidewalks.
Emails or calls (even if you are a plan member) if you opt out of this communication.
Ask for your personal information or try to sell you a plan at an educational exhibit.
Call, send text messages, or leave voicemail messages, unless you are already a plan member or gave the plan permission.

Plans can:

Send you mail.
Have educational exhibits at public events.
Call or email you about other health plans and products if you are ready a plan member and haven't asked them not to call or email.
Schedule an appointment to discuss plan options with you, but:
- Before the appointment, you must formally decide which topics will be discussed.
- The plan agent may not use your appointment or the time before or after to market or sell plans to other people in your building or neighborhood.

Seniors or their caregivers can report marketing violations by calling the NYS Senior Medicare Patrol at 800-333-4374. Make sure you have any information relating to the violation including the name of the person you spoke to, insurance company, date, location, and any other details about the incident.

Seniors can also call an Outreach Counselor for a free and confidential appointment to discuss their situation and review plan options. The New York StateWide Senior Action Council can assist with Medicare questions, plan comparisons, appeals and billing issues, Medicare Fraud, and Patient's Rights by calling StateWide at 800-333-4374 for free.

It is estimated that Medicare fraud costs taxpayers over $60 billion dollars nationally per year. To help combat this illicit industry StateWide announced its Fraud of the Month program in 2022 to highlight these scams being perpetrated on the State's seniors.

SOURCE New York StateWide Senior Action Council, Inc.