Medicare Drug Sign-ups Causing Concern Among Regulators

And consumers have been getting marketing material that is advertised as promoting Part “D” plans, but, in fact, is marketing other types of insurance such as long term care, as well, she noted.

The only authority state insurance regulators have for Part “D” is over agent activities, Burns said. “This is a good example of why federal regulation is not a good idea.”

There is concern among those working with Part “D” enrollees that there will be gaps in coverage or people will fail to act and be automatically enrolled in plans, she said. Prescription drug coverage for specific medications depends on the plan and/or if the drug is covered, there might be requirements such as prior approval, she added.

Gomez said that while regulators can take action against agents for improperly selling Part “D” plans, this is not an efficient means of regulating the marketing of those plans to consumers. Regulators are continuing dialogue with CMS, he added.

If an optional federal charter was in place, at least there would be a holistic approach to regulation rather than a mix of both federal and state oversight, said Bruce Ferguson, senior vice president-state relations with the American Council of Life Insurers, Washington. Consumer protection would have to be established through district offices and the idea of an OFC will only gain acceptance in Congress if consumer protections are in place, he added.

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