Kathryn A. Coleman, director of the agency’s Medicare Drug and Health Plan Contract Administration Group, said in a three-page letter that CMS is immediately upgrading its review of marketing materials, which must be submitted under its regulatory “File and Use” authority for Medicare Advantage and Part D drug plans, and “may exercise its authority to prohibit” their use, reports MedPage Today’s recent article entitled “CMS Puts the Kibosh on Misleading Medicare Advantage Sales Pitches.”
Medicare Advantage marketing materials can now go live five days after submission, provided the company submitting them “certifies the material complies with all applicable standards.” However, beginning on January 1, Coleman said no television advertisements will qualify to be submitted under its “File and Use” authority, meaning the ads will not run until CMS approves them.
Coleman said the agency is “particularly concerned with recent national television advertisements promoting MA [Medicare Advantage] plan benefits and cost savings, which may only be available in limited-service areas or for limited groups of enrollees, overstate the available benefits, as well as use words and imagery that may confuse beneficiaries or cause them to believe the advertisement is coming directly from the government.”
CMS is also looking at recordings of agent and broker calls with potential enrollees and is continuing its secret shopping of marketing events “by reviewing television, print, and internet marketing and calling related phone numbers and/or requesting information via online tools.”
CMS approved a final rule that requires all Medicare Advantage agents, brokers and third-party marketing organizations to record all their calls with potential enrollees “in their entirety, including the enrollment process.” In her letter, Coleman said reviews of recordings will continue.
“Our secret shopping activities have discovered that some agents were not complying with current regulation and unduly pressuring beneficiaries, as well as failing to provide accurate or enough information to assist a beneficiary in making an informed enrollment decision,” she wrote.
Coleman also noted that the agency will take “compliance action against plans for activities and materials that do not comply with CMS’ requirements.”
It also will review “all marketing complaints” received during the annual enrollment period, which runs from October 15 to December 7, and will target its “oversight and review on MA organizations and Part D sponsors with higher or increasing rates of complaints.”
Reference: MedPage Today (Oct. 21, 2022) “CMS Puts the Kibosh on Misleading Medicare Advantage Sales Pitches”