Kohl Reacts To AHIP's Most Recent Pledge To Clean Up Sales And Marketing Tactics Of Medicare Advantage Plans

Main Category: Medicare / Medicaid / SCHIP
Article Date: 05 Mar 2008 - 3:00 PDT

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U.S. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) reacted to a proposal put forth by America's Health Insurance Plans (AHIP) to put a stop to the deceptive and confusing marketing practices employed in the sale of Medicare Advantage plans to seniors. Karen Ignani, President and CEO of AHIP, presented the plan at a meeting with the Senate Finance Committee. Last month, Finance Committee Chairman Max Baucus (D-MT) held back-to-back hearings on the need for accountability and oversight of Medicare Advantage marketing and sales.

"We've heard pledges and promises from this group before," said Chairman Kohl, "but where's the follow-through? We can no longer wait for these companies to clean up their act while seniors continue to be duped and misled. It's time we give states more room to step up regulation and enforcement of the insurance industry in this arena. I commend Chairman Baucus for continuing to shed light on this issue."

The Aging Committee's ongoing investigation of private Medicare plans and providers has uncovered such questionable sales practices as removing seniors from traditional Medicare without their knowledge, signing seniors up for plans they cannot afford, and misleading seniors regarding which physicians and hospitals accept the plan. At the Aging Committee's May 2007 hearing, officials representing the state insurance commissions from Wisconsin, Oklahoma, and Georgia described a nationwide pattern of aggressive, and at times deceptive, marketing practices employed by Medicare Advantage sales agents. Ignani also testified at the May Aging Committee hearing, announcing at the time a new AHIP initiative to strengthen training for its members' agents and brokers.

In July, Chairman Kohl was joined by Senators Byron Dorgan (D-ND) and Ron Wyden (D-OR) in introducing the Accountability and Transparency in Medicare Marketing Act of 2007 (S. 1883). The bill would give state insurance commissioners the ability to develop standardized marketing and sales regulations of Medicare Advantage (MA) and Medicare prescription drug plans, and regulate both agents and companies in the marketing and sales of MA and prescription drug plans. If passed, the legislation would enable state insurance commissioners to adequately serve and protect Medicare beneficiaries in conjunction with the Centers for Medicare and Medicaid Services (CMS). Currently, states are largely pre-empted from regulating the marketing of MA and Medicare Part D plans. The marketing guidelines for these plans were established by CMS and have proven to be inadequate. Instead of regulating the abusive marketing practices, state authorities must refer complaints to CMS where some seniors have found that their complaints are not being resolved quickly and that the questionable practices are continuing.

During his opening statement at last May's hearing, Chairman Kohl insisted that the Aging Committee's oversight of this issue would be ongoing. "If more hearings are necessary to hold feet to the fire, we will hold them," said Chairman Kohl. "Cleaning up these marketing and sales practices is a priority of mine. Let me be clear, this issue will not go away after this hearing."

More information about the May 16 hearing is available here.

http://aging.senate.gov