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Christie Administration Warns NJ Seniors To Be Alert About Medicare Fraud

Governor Chris Christie’s Administration is urging consumers and health care providers to beware of unscrupulous or fraudulent activities during the annual Medicare open enrollment period, which runs from October 15 through December 7, 2012.

Governor Chris Christie
Governor’s Office/Tim Larsen

“Senior citizens face many important choices during the Medicare open enrollment period, such as whether to maintain their current insurance carrier, whether their current level of coverage is adequate and much more,” says New Jersey department of Banking and Insurance (DOBI) Acting Commissioner ken Kobylowski. “Before making a decision, they should review as much information as possible by looking at federal, state, insurance company, and health care provider websites and by asking direct questions to doctors, salespeople and carriers.”

Kobylowski wants seniors to be aware of the rules the Centers for Medicare and Medicaid Services (CMS) adopted to guide sales practices and to protect consumers from improper marketing activities. The rules apply to all Medicare plans, agents, and any contractors who work for these plans. The rules say that plans and agents: Must be licensed by the State; May not make unsolicited contacts, including door-to-door sales, cold calls or approaching you in a parking lot; Must have an appointment in advance before coming to your home;

Must arrange with you in advance the type of products that will be discussed during a scheduled sales appointment. They may not attempt to sell you other types of insurance coverage other than the type agreed upon in advance; May not try to sell you non-health care related products (like a life insurance policy or an annuity) during a sales or marketing presentation of a Medicare plan; May not attempt to sell you a plan in a doctor’s office or in a pharmacy; May not attempt to sell you a plan at an educational event; May not offer you free meals at promotional or sales events; and May not offer you gifts or other promotional items with a value greater than $15.

“As seniors review Medicare coverage options, which can be a challenge in itself, they must also be wary of fraud,” says Kobylowski. “Unfortunately there are some bad actors who seek to take advantage of senior citizens during open enrollment. But if seniors review all the information and exercise some basic precautions, they can avoid fraud and chose the insurance product that is best for them.”

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