Medicare Basics / SERS
Regulators Must Act Now to Pause Medicare Marketing Rule
By Janet Trautwein
Medicare's annual enrollment period began on October 15. So, it's all but impossible to miss the commercials featuring celebrities pitching Medicare Advantage plans to seniors.
Half of Fame quarterback Joe Namath is telling seniors they can get extra Medicare benefits by calling a 1-800 number. Actor Jimmie Walker is advising them to call -- NOW! -- to check whether they're eligible for plans that could be "Dyn-O-Mite." William Shatner is imploring seniors to get the benefits they deserve.
The ads are enticing -- and sometimes misleading. In response to an increase in complaints about the commercials and other Medicare marketing strategies, the Centers for Medicare and Medicaid Services recently issued more stringent requirements for companies advertising on behalf of Advantage and Part D prescription drug plans.
More oversight is sorely needed. But the new CMS marketing rule may end up depriving seniors of access to licensed, Medicare-certified independent agents and brokers who can help them with enrollment. The Department of Health and Human Services must press pause on the new rule.
Persuading seniors to sign up for Medicare Advantage -- the privately administered plans that are an alternative to traditional Medicare -- and the Part D prescription drug benefit is big business.
Sometimes, seniors don't realize until after they've enrolled that their current doctor isn't in their new insurance plan's network, or that the extra "benefits they deserve" aren't actually available in their region.
Seniors have understandably grown frustrated. CMS received over 41,000 consumer complaints about misleading Medicare marketing tactics last year -- a 165% increase from 2020.
That led CMS to finalize a Medicare marketing rule aimed at increasing oversight of the practices of third-party marketing organizations that help sell private Advantage and Medicare Part D plans.
These reforms are all well-intentioned. But part of the rule could swiftly undo any progress in the fight against unscrupulous marketing tactics by bad actors.
The rule expands the definition of third-party marketing organizations to include agents and brokers. So, agents and brokers must now record enrollment calls -- a huge burden that could strip millions of Medicare beneficiaries of access to a licensed agent or broker.
There's been little clear guidance from HHS about what actually constitutes an enrollment call. So many agents and brokers, who often spend hours exploring a beneficiary's unique circumstances and combing through potential plans for the best fit, are preparing to record every conversation they have with their clients.
That requires equipment that can record and store hours-long audio files for years at a time -- and do so securely, to comply with federal privacy laws.
That's cost-prohibitive for many small agencies and brokerages. Further, some seniors don't want their enrollment calls recorded, given that they touch on extremely personal information.
Seniors who have relied on agents and brokers for decades now face the prospect of having to sign up for Medicare without their expert counsel.
Federal officials can stop that from happening by pausing implementation of the rule -- and developing new reforms that protect seniors from bad actors without jeopardizing access to agents and brokers.
Medicare's annual enrollment period is already here. HHS can ensure seniors have the ability to enroll in plans that best fit their needs and budget. But it has to act NOW!
(Janet Trautwein is CEO of the National Association of Health Underwriters - www.nahu.org)
