Senator urges CMS to approve its proposed Medicare Advantage policy changes

The Centers for Medicare & Medicaid Services in mid-December proposed a rule for Medicare Advantage policy changes for 2024, including steps to curb deceptive marketing practices by insurance agents and brokers. Public comments on the proposed rule closed on Monday.

However, earlier this week, Senate Finance Committee Chair Ron Wyden, D-Ore., urged approval of the rule in a letter to CMS Administrator Chiquita Brooks-LaSure:

“The Medicare Advantage program has provided Oregonians and Medicare beneficiaries around the country with value by offering plans that coordinate care and invest in the long-term health of their enrollees,” Wyden wrote. “However, it has become clear that not all enrollees are seeing that value or being put first. I strongly support the proposed rule as it seeks to restore important protections against deceptive and fraudulent marketing tactics; expands access to non-physician behavioral health providers; and promotes health equity for historically underserved communities.”

Last year, Wyden, who has long pushed for drug pricing reform, released an investigation showing how private agents and brokers use high-pressure tactics, misleading language, unsolicited cold-calls and the use of the Medicare name and logo in marketing and branding that can mislead seniors into mistaking private agents and brokers for the federal government.

Related: More employers moving retirees to Medicare Advantage: Here’s why

Several marketing changes for Medicare Advantage and Part D in the proposal, which would take effect Jan. 1, 2024, would affect employers and benefits professionals. They include:

• Notifying enrollees annually, in writing, of the ability to opt out of phone calls.
• Requiring agents to explain the effect of an enrollee’s enrollment choice on their current coverage whenever the enrollee makes an enrollment decision.
• Requiring agents to share certain information with potential enrollees when processing enrollments by phone.
• Simplifying plan comparisons by requiring medical benefits to be in a specific order and listed at the top of a plan’s summary of benefits.
• Limiting the time that a sales agent can call a potential enrollee to no more than six months following the date that the enrollee first asked for information.
• Prohibiting marketing of benefits in a service area where those benefits are not available.
• Prohibiting the marketing of information about savings based on a comparison of typical expenses borne by uninsured individuals, unpaid costs of dually eligible beneficiaries or other unrealized costs of a Medicare beneficiary.
• Limiting use of the Medicare name, logo and Medicare card.
• Prohibiting most use of words such ‘‘best’’ or ‘‘most’’ in marketing.