Close Close

Life Health > Health Insurance > Medicare Planning

Agency: CMS Weak At Watching Marketing

Your article was successfully shared with the contacts you provided.

Federal watchdogs say the Centers for Medicare and Medicaid Services should do a better job of overseeing Medicare Part D prescription drug program marketing efforts.

Officials in the Office of the Inspector General at the U.S. Department of Health and Human Services contend in a review of marketing materials for Medicare prescription drug plans that CMS should conduct and complete more frequent reviews of marketing materials that are already in consumers’ hands.

CMS depends heavily on backward-looking “retrospective reviews” to determine whether marketing materials meet its standards, but the agency did not review 2006 “file and use” materials until April 2008, OIG officials write in a summary of their findings.

The officials based their findings on an analysis of marketing materials from 115 randomly selected Medicare drug plans.

OIG officials found that 85% of the marketing materials reviewed failed to meet at least one element of the CMS marketing material guidelines:

- 79% of advertisements prepared by insurer-pharmacy teams failed to include a required statement that other pharmacies were also available.

- 42% of the pharmacy directories did not tell beneficiaries what to do if mail-order service was delayed.

- 37% of the enrollment forms left out the Medicare telephone number aimed at beneficiaries who are deaf at places in the forms where the ordinary Medicare 800 assistance line was listed.

- 17% of the plan formulary lists included only a listing organized by therapeutic class, without offering users the required alphabetical list of covered drugs.

CMS officials told OIG officials that they depend partly on drug plan managers to keep tabs on competitors’ marketing materials.

“However, CMS officials could not provide us with the number or type of complaints received from sponsors monitoring each other,” OIG officials write.

CMS Acting Administrator Kerry Weems writes that CMS agrees with the OIG officials on the need to improve marketing materials reviews and already has implemented many changes.

CMS was swamped in 2006 when the inflow of materials requiring reviews increased dramatically, Weems writes.

“CMS has completed its first national retrospective review and is conducting its second,” Weems writes. “Additionally, CMS is developing its standard operating procedure for future reviews.”


© 2023 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.