The sale of Medicare Advantage plans by sales agents and brokerages is heavily regulated by the federal government. When agents sell Medicare Advantage plans, they receive commissions that are funded by federal money. But in order to receive these commissions, the agents have to follow a series of rules and regulations that are designed to protect vulnerable Medicare beneficiaries.


In order to qualify to sell Medicare Advantage plans, agents must pass a number of tests. The testing is designed to ensure that the agents both know the details of the plans they are selling and that they are aware of the prohibitions against waste, fraud and abuse.


These tests must be taken by the agents alone and they must be conducted with integrity.  Agents cannot have other people take their tests for them. Agents cannot have other people give them the answers in the tests.   Medicare Advantage insurance companies are responsible for ensuring that these tests are taken with integrity. 


The regulations governing the sale of Medicare Advantage plans also have other protections for beneficiaries. For example, Medicare Advantage sales agents are not allowed to contact a Medicare beneficiary in person without the beneficiary's permission.  Consequently, unsolicited "door-to-door" sales of Medicare beneficiaries to sell Medicare Advantage plans is illegal.  


Medicare Advantage agents also cannot "churn" business, i.e., switching a beneficiary who has a Medicare Advantage plan for the sole reason of getting the commission associated with the sale of a new plan. 


If you are a Medicare Advantage sales agent who works for a company or a brokerage that does not administer the Medicare Advantage tests with integrity, directs you to engage in unsolicited "door-to-door" sales of Medicare Advantage plans, or directs you to "churn" Medicare Advantage business please contact me for a free evaluation of your potential case:


Email: pepper@jamespepperlaw.com


Telephone: 215-340-2500 or 267-994-2110



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MEDICARE ADVANTAGE SALES FRAUD