Senate Bill Seeks To Improve Medicare Handbook Amid Spike In Marketing Complaints

Bill seeks to improve Medicare handbook after marketing concerns

Source: Fierce Healthcare, by Robert King

New legislation seeks to improve the Medicare & You handbook in the latest attempt by Congress to scrutinize how Medicare Advantage plans are marketed to seniors.

The legislation introduced Tuesday by Sens. Maggie Hassan, D-N.H., and Roger Marshall, R-Kan., would add new information to the handbook on health plan choices and supplemental insurance. It is the latest bid by lawmakers to address a spike in complaints among seniors over aggressive marketing practices for MA plans.

“I’ve grown increasingly concerned about mass marketing ad campaigns during open enrollment, and want to be sure that seniors are selecting plans that best meet their health and financial needs,” said Marshall in a statement.

The handbook guides new and current Medicare beneficiaries on the program, which is in the middle of open enrollment through Dec. 7.

It includes a summary of Medicare benefits, available health and drug plans as well as frequently asked questions. While the handbook does compare Medicare and MA, it doesn’t discuss how MA plans can control costs.

The legislation would include information in the handbook on how MA plans rely on drug cost controls like step therapy and prior authorization. It also discusses network sizes in MA, a key difference compared with traditional Medicare.

The legislation would also add an explainer on what happens if a senior switches to MA and go back to traditional Medicare.

“They may be prohibited from purchasing supplemental coverage or else have to pay significantly higher premiums,” a release on the bill said.

The legislation is the latest effort by the Senate to scrutinize MA marketing.

Senate Finance Committee Chairman Ron Wyden, D-Ore., released a report earlier this month showing that nine states have experienced a higher rate of complaints over MA marketing practices. A common complaint was that mailers were sometimes tailored to be official government documents.

The report found that some plans were marketing to beneficiaries that had dementia or enrolled in a plan without their consent.

Wyden has called for the Centers for Medicare and Medicaid Services to adopt several recommendations that include holding brokers and agents accountable for their actions and closing a loophole that enables cold calling to seniors.

CMS has said it is looking at the recommendations. The agency issued a guidance document last month that reminded plans they are responsible for the actions of brokers and agents hired on behalf of the plans.

Starting next year, CMS will also preapprove any MA television spots. Currently, such spots can air before getting agency approval.

Last Updated 12/07/2022

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