[Co-Author: Sheela Ranganathan, Law Clerk]
On Monday, we discussed that the Centers for Medicare and Medicaid (“CMS”) has heightened oversight of Medicare Advantage (“MA”) organizations’ and Part D sponsors’ marketing practices. We also noted that the United States Senate Committee on Finance (the “Committee”) sent letters to 15 state insurance commissioners and state health insurance assistance programs, requesting data and information on MA marketing complaints in August 2022. Yesterday, the Committee, chaired by Ron Wyden, released a report entitled Deceptive Marketing Practices Flourish in Medicare Advantage (“the Report”).
The Report found that there was an increase in complaints about mail advertisements, television advertisements, telemarketers, and robo-calls. States also reported marketing of plans to beneficiaries with dementia, beneficiaries being enrolled in a new plan without their consent, and examples of beneficiaries being switched to plans that did not cover their providers, all of which led to substantial disenrollment.
Hours after the Report was released, the New York Times reported on the magnitude of the complaints within the Report, noting that companies selling Medicare plans to older adults have posed as the Internal Revenue Service and other government agencies.
The Committee has urged CMS and Congress to take the following actions:
When CMS finalized its new regulations on third party marketing organizations, it indicated the possibility of issuing even more regulations and guidance to address abusive marketing practices. The Report likely means that CMS is one step closer to issuing additional requirements for Medicare Advantage organizations, Part D sponsors and third party marketing organizations.
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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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