New rules aim to stop deceptive Medicare Advantage marketing Skip to content

New rules aim to stop deceptive Medicare Advantage marketing

If you are old enough, you have no doubt been inundated with calls and mail about Medicare Advantage. Some of these are deceptive, and CMS wants to end the deception.

Those incessant ads and phone calls about Medicare, and other marketing devices that the federal government considers deceptive, are about to get makeovers. At least, that’s what the feds have in mind.

On April 5, the Centers for Medicare and Medicaid Services “finalized a slew of Medicare Advantage marketing reforms for the upcoming 2024 Medicare open enrollment season, including plans to crack down on general television advertisements after concerns over such marketing kicked into high gear last year,” Michelle M. Stein reports for Inside Health Policy.

CMS said last fall that it was worried about marketing practices, particularly TV commercials for Medicare Advantage, which most Medicare beneficiaries now have. Private insurance companies run MA plans, making money by getting a flat fee from Medicare for covering each beneficiary, then controlling costs by limiting claims payments and taking other measures.

The Senate Finance Committee fanned those flames with a report that alleged bad actors in 14 states were taking advantage of loopholes and lax rules around marketing and enrollment, “badgering seniors on the phone, confusing them on television, and inundating them with mountains of mail,” and noting complaints to CMS doubled between 2020 and 2021.

“Widespread television advertisements with celebrities claim that seniors are missing out on benefits, including higher Social Security payments,” the report said, calling the ads deceptive. It urged CMS to act.

CMS said, “The proliferation of certain television advertisements generically promoting enrollment in MA plans has been a specific topic of concern. To address these concerns, CMS is prohibiting ads that do not mention a specific plan name as well as ads that use words and imagery that may confuse beneficiaries or use language or Medicare logos in a way that is misleading, confusing, or misrepresents the plan.”

The proposed regulations would also require insurers to:

  • Notify enrollees annually and in writing of their ability to opt out of phone calls regarding Medicare Advantage and Part D;
  • Explain the effect of an enrollee’s enrollment choice on their current coverage when they make an enrollment decision;
  • Simplify plan comparisons by requiring medical benefits be in a specific order and listed at the top of plans’ Summary of Benefits;
  • Ban marketing of savings information based on a comparison of typical expenses for uninsured individuals or the unpaid costs of beneficiaries eligible for both Medicare and Medicaid;
  • Limit the use of the Medicare name, logo, and card in ads.

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Kentucky Health News

Kentucky Health News is an independent news service of the Institute for Rural Journalism, based in the School of Journalism at UK, with support from the Foundation for a Healthy Kentucky.

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