• Hypertrophic Cardiomyopathy (HCM)
  • Vaccines: 2023 Year in Review
  • Eyecare
  • Urothelial Carcinoma
  • Women's Health
  • Hemophilia
  • Heart Failure
  • Vaccines
  • Neonatal Care
  • Type II Inflammation
  • Substance Use Disorder
  • Gene Therapy
  • Lung Cancer
  • Spinal Muscular Atrophy
  • HIV
  • Post-Acute Care
  • Liver Disease
  • Biologics
  • Asthma
  • Atrial Fibrillation
  • RSV
  • COVID-19
  • Cardiovascular Diseases
  • Prescription Digital Therapeutics
  • Reproductive Health
  • The Improving Patient Access Podcast
  • Blood Cancer
  • Ulcerative Colitis
  • Respiratory Conditions
  • Multiple Sclerosis
  • Digital Health
  • Population Health
  • Sleep Disorders
  • Biosimilars
  • Plaque Psoriasis
  • Leukemia and Lymphoma
  • Oncology
  • Pediatrics
  • Urology
  • Obstetrics-Gynecology & Women's Health
  • Opioids
  • Solid Tumors
  • Autoimmune Diseases
  • Dermatology
  • Diabetes
  • Mental Health

Feds limit deceptive MA marketing tactics


Washington, D.C. - The Bush administration has proposed additional curbs on certain sales practices by insurers likely to confuse and deceive seniors enrolling in Medicare Advantage and prescription drug plans. Insurers applauded the marketing policy, partly in hopes of heading off legislation that would give states a larger role in policing Medicare marketing activities.

The new rules from the Centers for Medicare and Medicaid Services (CMS) prohibit cold-calling and door-to-door solicitation of Medicare beneficiaries, along with cross-selling health plans with life or disability insurance. Insurers can't promote plans at health fairs or community meetings. Plan sponsors also have clear responsibility for marketing activities by independent agents and can't set commissions or payments in ways that encourage high-powered sales activities or beneficiary churning. And insurers that violate the rules will face hefty fines.

These prohibitions are similar to those proposed by insurers in March. A Medicare marketing policy backed by members of America's Health Insurance Plans (AHIP) opposed cold-calling, door-to-door sales, cross-selling and inducements such as free meals or prizes to persuade seniors to sign up for private plans. Insurers say they are increasing agent training to clarify prohibited sales tactics and are revising commission and bonus standards to discourage quick sales and efforts to shift seniors from one plan to another.

To codify the CMS policy, Senate Finance Committee Chairman Max Baucus (D-Mont.) wants to incorporate the administration's new rules into a broader Medicare bill moving through Congress.

A key issue is whether Congress also revises current law to give state regulators added authority to enforce marketing standards for private Medicare plans. One reason insurers support stiffer federal marketing rules is to avoid the need to comply with 50 different state policies.

The National Association of Insurance Commissioners (NAIC) and state officials have urged Congress to revise this policy so that they can enforce marketing and sales rules for private Medicare plans and can help resolve consumer complaints in this area. To address insurers' concerns, NAIC is proposing to develop model marketing standards for MA and Medicare drug plans that states would have to adopt in order to be able to police these plans.

Sen. Herb Kohl (D-Wis.), chairman of the Senate Special Committee on Aging, has urged legislation that gives states a larger role in policing illegal Medicare sales tactics. Kohl is skeptical that federal efforts will protect seniors sufficiently and wants states to step up regulation of the insurance industry.

Related Videos
Video 11 - "Closing Current Gaps within Fertility Benefits and Care"
Video 10 - "Shaping Fertility Coverage: Access, Costs & Medical Needs"
Video 9 - "Denial of Coverage in Fertility Care"
Video 8 - "Risks of Miscarriage and Multiple Births Associated with Fertility Care"
Video 7 - "Fertility Preservation: Egg Freezing Versus Embryo Freezing"
Video 6 - "Family Building Costs, Barriers, and Dropout Rates Associated with Fertility Care"
Video 5 - "Closing Payer Gaps and Improving Fertility Care Access"
Video 4 - "Increasing Employer Coverage and Maximizing Fertility Benefits "
Video 5 - "Relevance of NUTURE Study Findings for Patients, Payers, Providers"
Video 3 - "Improving IVF Success Rates & Utilizing AI in Fertility Health Care"
Related Content
© 2024 MJH Life Sciences

All rights reserved.