Timothy J. Murphy, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Boston office, was quoted in Modern Healthcare, in “Fraudsters Hit Exchanges Amid Medicare Advantage Crackdown,” by Nona Tepper. (Read the full version – subscription required.)
Following is an excerpt:
Unscrupulous insurance marketers vexed by a federal push against Medicare Advantage fraud found a more hospitable environment on the health insurance exchanges, brokers say.
The Centers for Medicare and Medicaid Services implemented regulations earlier this decade to address concerns that beneficiaries shopping for private Medicare plans were being misled and victimized. Meanwhile, health insurers became more bullish about the growing marketplaces, and leading carriers began offering commissions for exchange plan sales, making this market more attractive to brokers and other third-party marketing firms. …
The connection between CMS making fraud more difficult to pull off in Medicare Advantage, insurers reducing or eliminating compensation for Medicare Advantage sales, big carriers expanding their exchange businesses, and a flurry of improper enrollments in exchanges plans is clear, said Tim Murphy, an attorney at the law firm Epstein, Becker & Green.
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