House Members Mull Medicare Marketing Bill

Lawmakers talked today about developing legislation to fight overly aggressive Medicare Advantage plan sales efforts.

Possibilities such as classifying certain Medicare Advantage plan sales practices as fraud, limiting the number of different types of Medicare Advantage plans that can be sold, and giving state insurance regulators more authority to regulate Medicare Advantage plan sellers came up during a hearing on Medicare Advantage sales practices that was convened by Rep. Bart Stupak, D-Mich., chairman of the House Energy and Commerce Committee oversight subcommittee.

Medicare Advantage program supporters say the flexibility of the program helps insurers design affordable benefits packages that Medicare beneficiaries really want, but Stupak said the flexibility of the program may be contributing to marketing problems.

“In Houghton, Mich., Medicare beneficiaries have 54 prescription drug plans to choose from plus 14 Medicare Advantage plans,” Stupak said. “That is nothing compared to other parts of the country. For instance, in Miami, there are at least 57 prescription drug plans and 55 Medicare Advantage plans available.”

Stupak also questioned a recent move by several Medicare private FFS insurers to suspend private FFS sales while the insurers work with the Centers for Medicare & Medicaid Services to revamp their marketing programs.

“The industry and CMS may claim they have ‘zero tolerance’ for deceptive sales practices, but what America’s seniors need is zero abuse,” Stupak said.

Today, despite a prohibition on door-to-door marketing of Medicare private FFS plans, “agents arrive on residents’ doorstep stating that the ‘president’ sent them or that they represent Medicare,” according to Kathleen Healey, director of the Alabama State Health Insurance Assistance Program. “These agents bear business cards touting themselves as ‘Medicare specialists’ or ‘senior service specialists,’ not insurance agents.”

Insurance regulators from Mississippi, North Dakota and Oklahoma testified at the hearing that they believe they have only very limited enforcement authority over the companies and individuals selling Medicare Advantage plans.

“I sit before you today to urge you to restore state regulatory authority over these programs,” said North Dakota Insurance Commissioner Jim Poolman. “Consider using the current Medigap insurance as a regulatory model.”

The staff at the CMS is “ill-equipped” to address Medicare Advantage plan members’ problems, Poolman said.