Medicare Advantage lobby rebuts senator’s inquiry into ‘potentially deceptive’ marketing tactics

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Dive Brief:

  • A major group representing Medicare Advantage plans is pushing back at Senate Finance Chair Ron Wyden, D-Ore., following the senator’s request to more than a dozen states for data on the “potentially deceptive” marketing tactics of payers offering the lucrative and privately-run Medicare and Part D plans.
  • Marketing materials for MA plans are already subject to “careful regulation,” must be approved by regulators and adhere to a 53-page set of federal guidelines, Better Medicare Alliance leader Mary Beth Donahue argued in a Tuesday statement on the inquiry.
  • Wyden’s request comes amid reports of complaints from MA beneficiaries over practices like aggressive sales techniques and fraudulent and misleading advertisements, according to the senator’s letter.

Dive Insight:

MA plans, which say they offer lower costs, extra benefits and better outcomes, are growing in popularity — estimates place more than half of all Medicare beneficiaries in the privately-run plans by 2025. Industry-funded polling show the majority of MA beneficiaries are happy with their coverage and would recommend MA to family and friends.

But the plans have come under rising scrutiny for fraud, false billing and misleading marketing tactics, sparking Wyden’s inquiry.

Wyden last week sent letters to 15 states, including California, New York and Texas, requesting they provide information by mid-September on complaints from people enrolled in MA, so lawmakers can better understand any advertising or enrollment issues in the coverage when crafting legislation.

According to the letter, the CMS received more than twice the number of complaints about MA plans in 2021 than it did in 2020, mostly from third-party marketing organizations. As a result, the agency proposed a rule earlier this year to strengthen oversight of third-party marketing groups by mandating a disclaimer that they don’t offer every plan available in the area, among other measures.

In the BMA’s statement, Donahue argues that enrollment in MA is an active choice, and despite increasing marketing on behalf of plans, almost half of seniors still don’t know the option of MA exists.

Instead of “criticizing those standing in the gap to help beneficiaries navigate this difficult and complicated process,” policymakers should “modernize Medicare enrollment in ways that offer more transparency in coverage choices and empower consumers,” the BMA president and CEO said.