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The Reluctant Regulator: Centers for Medicare and Medicaid to Marketing Misconduct by Medicare

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Abstract:

Across the country, there is a growing chorus of advocates, state insurance departments, the media, members of Congress, and people with Medicare voicing complaints about aggressive and deceptive marketing of Medicare private plans to older adults and individuals with disabilities. Until very recently, the Centers for Medicare and Medicaid Services (CMS) and the insurance industry have largely blocked out these voices. CMS has, of late, taken steps designed to stem marketing misconduct, particularly with respect to the sale of one type of Medicare Advantage plan, Private Fee-for-Service (PFFS) plans. In this brief, we continue our analysis of problems relating to the marketing of private Medicare plans by evaluating the effectiveness of CMS's response to reports of marketing misconduct, assessing the potential benefits of increased state oversight and enforcement and proposing additional policy recommendations that address the root causes of marketing misconduct.