There has been quite a bit of discussion on METAR about the problems with Medicare Advantage when the insurance companies which administer the program deny coverage.
Apparently, an even worse problem is deceptive advertising – so bad that the Centers for Medicare and Medicaid Services is writing a new rule to prohibit deceptive ads. It’s about time! One of the main jobs of a different agency (the FDA) is targeting deceptive medical advertising.
By AMANDA SEITZ, AP News, 12/14/2022
The rule, proposed by the Centers for Medicare and Medicaid Services, would ban ads that market Medicare Advantage plans with confusing words, imagery or logos. The new regulation would also prohibit ads that don’t specifically mention a health insurance plan by name.
It’s an aggressive step to tackle a growing problem in the Medicare Advantage marketplace, a booming business that offers privately run versions of the government’s Medicare program for people who are 65 and older or have disabilities. Nearly half of all Medicare enrollees — about 28 million — are now turning to Medicare Advantage plans…
[snip examples of misleading advertising designed to trick seniors]… [end quote]
Here is the press release from CMS. It addresses concerns of 4,000 responders to the CMS request for opinions about Medicare Advantage. And there were a lot of concerns from coverage to advertising.
Here is the fact sheet on the proposed rule.
Since this is a proposed rule, I don’t know what it will take to implement it or how long until approval is finalized. I’m also not clear about how CMS will enforce the rule since there don’t seem to be any penalties for violating rules…not to mention that most Medicare beneficiaries probably won’t know the rules or how to report violations.
Still, it’s a step in the right direction. It’s a Macroeconomic issue because it affects tens of millions of dollars and half the Medicare program which is a giant slice of the federal budget.
Wendy