FTC SUES TO STOP DECEPTIVE HEALTH CARE SCHEME
The following information was released by the
At the
According to the Commission's complaint, the schemewhich operates under several names including
This action follows
"Targetingunlawful conduct that drives up Americans' costs, especially healthcare costs, is one of my top priorities," said Chairman
The
The complaint further alleges that when dealing with consumers who already have health insurance, the company's telemarketers deceptively tell them they are calling from real insurance carriers or the government, and that without immediate payment their policies will be canceled.
The products the defendants sell are not PPO plans or comprehensive health insurance policies, and they cannot be sold on any state or federal government health insurance marketplace, according to the complaint. Instead, the defendants' plans typically include an assortment of medical discounts, ancillary products, and capped payouts for certain medical events such as emergency room visitswhile some plans exclude hospital care entirely.
While at least one defendant has claimed they do not market or sell insurance, the defendants lead consumers to believe the products they offerwhich can cost hundreds of dollars a month and thousands of dollars a yearwill provide comprehensive coverage, according to the complaint.
The complaint further alleges that when consumers who enroll in the defendants' supposed PPO policies attempt to use them, they discover that the products do not provide the comprehensive coverage they were promised. As a result, some are forced to postpone care until they can get insurance coverage, while others are faced with substantial medical debt. When frustrated consumers try to cancel their purchase of the products, the defendants often ignore them and the monthly payments continue.
In addition, the complaint alleges that the defendants:
unfairly charge consumers without their express, informed consent and fail to disclose material terms and conditions of their negative option feature, specifically the steps consumers must take to cancel the monthly recurring payments;
make misrepresentations while telemarketing and fail to disclose material information in telemarketing before the consumer consents to pay for the goods or services provided;
engage in unlawful telemarketing acts and practices by charging consumers for products or services for which they have not provided their express, informed consent;
deceptively pose as businesses and government officials or misrepresent their affiliation with, or endorsement or sponsorship by, a government entity; and
use false, fictitious, or fraudulent statements or representations to obtain customer information of a financial institution, such as credit or debit card numbers.
The complaint alleges that the defendants violated the FTC Act, the Telemarketing Sales Rule, the Impersonation Rule, and the Gramm-Leach-Bliley Act and seeks refunds for affected consumers. The court entered a temporary restraining order against the defendants based on their alleged law violations.
The Commission vote authorizing the staff to file the complaint against the six defendants was 2-0. The complaint was filed under seal in the
The defendants include
NOTE:The Commission files a complaint when it has "reason to believe" that the named defendants are violating or are about to violate the law and it appears to the Commission that a proceeding is in the public interest. The case will be decided by the court.
Staff attorneys on this matter are



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