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Regulation and Compliance > State Regulation

States React To Medicare Plan Complaints

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State insurance regulators say they will be asking Congress to give them more authority over the agents selling Medicare Advantage plans and Medicare drug plans.

The National Association of Insurance Commissioners, Kansas City, Mo., is preparing a white paper that will describe the complaints the regulators are receiving and propose changes in the federal laws governing regulation of Medicare plan agents.

In Florida, for example, investigations of Medicare Advantage plan agents in the state increased 515% between 2006 and 2007, according to Mary Beth Senkewicz, a Florida deputy insurance commissioner.

Under current law, states regulate solvency and licensing of private Medicare plans, but the federal government handles all other aspects of Medicare plan regulation, according to Guenther Ruch, an official with the Wisconsin insurance commissioner’s office.

State regulators want authority over agents and the ability to apply the Unfair Trade Practices Act to those agents as well as the authority to hold companies accountable for the acts of their agents, Ruch says.

Ruch says state regulators do not want to be involved in continuing relations between plans and the Centers for Medicare and Medicaid Services, contracting or submission of plan materials, the approval of advertising, or premium bidding practices.

NAIC officials hope to complete the Medicare plan regulation white paper in June.

The individuals writing the paper plan to meet May 20 in Washington to work on the current draft.

Ruch says the current draft of the white paper includes recommendations that:

- Advertisements and marketing materials should specify the type of plan being offered and should avoid adjectives such as “gold,” “silver” or “value.”

- Agents selling Medicare plans should not be able to sell seniors other products, such as annuities or long term care insurance, while they are selling the Medicare plans.

- Insurers should notify states of all agents selling Medicare plans and should disclose commissions that the agents receive for selling the plans.

The draft version of the white paper attributes the recommendations in the draft to the parties that suggested the recommendations, Ruch says.


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