Medicare Scam Crackdown Hits Fresno Business

FRESNO, Calif.

Hussein Osman Ali is a convicted felon who's accused of using deceptive practices to sell Medicare Advantage plans and collect big bonuses. Ali told Action News he's never sold the plans, he just manages people who do, and he says the government hasn't told him about any sanctions.

Behind the closed door at Brawley Insurance Services, Ali leads a team of insurance sales people. The company's website says it offers a full menu of Medicare Advantage plans -- a relatively new type of policy offering Medicare insurance plus extra coverage.

State agents say the plans also offer an in for crooks.

"These plans can be very beneficial for consumers, but unfortunately they have also given an opportunity for those who would take advantage of elderly or vulnerable consumers," said Brent Barnhart, the head of California Department of Managed Health Care.

Insurers pay agents hundreds of dollars in incentives to sign up new Medicare Advantage patients. State agents say that often leads to unscrupulous sales methods.

In Manteca, Brenda Hoot fell victim to the hard sell, then found herself sinking into debt as bills stacked up that her old policy would've paid. "I was getting thousands and thousands of dollars in bills and I was calling this lady," Hoot said. "She said it was all a mistake and she'd take care of it. She didn't."

State investigators are looking into Hoot's complaint and about 100 others across the state.

A complaint about Brawley Insurance Services led to sanctions preventing the company from selling any more Medicare policies. But some victims say that's not enough to stop the scams.

"They get a slap on the wrist, but what about us?" Hoot said. "You know, our credit's bad, some doctors won't see us because they didn't get paid. It's been a nightmare."

Open enrollment for Medicare Advantage starts on Saturday, so state agents want seniors and their families on alert.

As for Ali, he says he's selling Brawley Insurance Services and getting out of the Medicare business, but not until after the open enrollment period.

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People with questions or complaints about Medicare Advantage plans should contact the DMHC's Help Center at 1-888-466-2219 or at www.healthhelp.ca.gov.

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