Medicare Advantage has a marketing problem
Complaints about aggressive marketing tactics and other issues connected with private Medicare plans are surging, according to CMS data shared with Axios.
Why it matters: While enrollment in Medicare Advantage has risen every year since 2007, according to a KFF report, so, too, have questions about the quality of care and whether the program is becoming a haven for high-pressure sales tactics and scammers.
- Senate Finance Chair Ron Wyden (D-Ore.), launched an investigation last month, requesting information from 15 state regulatory bodies, including examples of false or misleading marketing materials.
- This week, House Ways and Means Health Subcommittee Chair Lloyd Doggett (D-Texas), led 30 other Democratic members in recommending changes to the program that included reining in aggressive and misleading marketing tactics.
- "Aggressive sales tactics have left vulnerable seniors and people with disabilities susceptible to being misled and unwillingly steered into Medicare Advantage plans," the House members wrote to CMS administrator Chiquita Brooks-LaSure.
Details: The number of complaints by beneficiaries about third-party organizations marketing Medicare Advantage and Part D drug coverage products has sharply risen every year since 2017, according to the CMS data.
- Complaints include beneficiaries being enrolled without any contact with a health plan, cross-selling and misleading information about provider networks, reimbursements, benefits and premiums.
- CMS received almost 40,000 complaints from beneficiaries about the marketing of plans last year, up from about 5,700 in 2017.
- A CMS spokesperson said in a statement that the agency is trying to ensure beneficiaries get "accurate and accessible information about Medicare coverage," including strengthening oversight of third-party marketing organizations.
CMS this spring required marketers to include disclaimers in advertisements about plan information, to discourage deceptive sales practices.
- The National Association of Insurance Commissioners sent a letter to Congress in May asking for states to be given the authority to regulate advertising and marketing of Medicare Advantage plans, which is now subject to federal oversight.
What they're saying: Wyden told Axios that Medicare Advantage plans will be a continued focus of his committee.
- "I've been concerned about the growing number of complaints that have been reported," said Wyden. "I've really come to the conclusion that not all MA is created equal. There's some that is quite good and there are some ones that we have some questions about, and that's what we're doing."
Yes, but: The top advocacy group for private Medicare plans, the Better Medicare Alliance, said the sector already is subject to regulatory oversight, including answering to more than 50 pages of federal guidelines.
What we're watching: With the Medicare open enrollment season starting again on Oct. 15, there will be added scrutiny of information on plan options and other marketing materials.