Democratic Lawmakers To Propose Restrictions On Private Medicare Advantage Plan Sales Tactics

Main Category: Medicare / Medicaid / SCHIP
Article Date: 08 Feb 2008 - 10:00 PDT

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Democratic lawmakers are developing legislation that would prohibit certain marketing practices used by private Medicare Advantage plans after some seniors complained of aggressive sales tactics, the AP/San Jose Mercury News reports. Although the Bush administration has imposed some new regulations on MA plan marketing over the past year, Senate Finance Committee Chair Max Baucus (D-Mont.) said many lawmakers are not satisfied with the results.

The Bush administration has required some private MA plans to call beneficiaries after they sign up for coverage to ensure they understand that they are not enrolled in traditional Medicare. In addition, the administration has developed a "secret shopper" program to monitor sales agents' marketing presentations.

The legislation would ban door-to-door sales of MA plans and prohibit insurers from using call centers to find potential sales leads. Carol Guthrie, a Baucus spokesperson, said that another provision of the measure would prohibit agents from representing themselves as being from the Medicare program. In addition, the measure would make it illegal for insurers to pay agents bonuses or commissions based on the number of new beneficiaries they enroll, according to Guthrie. She said Baucus also wants to give states more power to regulate private MA plan marketing practices.

Peter Ashkenaz, a spokesperson for CMS, said the legislation is unnecessary because the practices it targets already are banned through regulations and contract requirements. In addition, he said the agency has sanctioned insurers whose sales agents have taken advantage of Medicare beneficiaries. Officials from America's Health Insurance Plans said that the trade group would work with the Finance Committee on the legislation but that the measure is irrelevant because the concerns are already covered by regulations and voluntary guidelines put in place by the industry (Freking, AP/San Jose Mercury News, 2/6).

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