Kentucky Health News
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, Michalle M. Stein reports for Inside Health Policy.
CMS said last fall that it was worried about marketing practices, particularly concerned about 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:
- Notifying 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;
- Simplifying 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.