Tougher Medicare Marketing Rules on Tap

“Real integrity is doing the right thing, knowing that nobody's going to know whether you did it or not.”—Oprah Winfrey

The Bush administration has apparently had it with unscrupulous agents who peddle inappropriate Medicare plans to unsuspecting seniors. The Centers for Medicare and Medicaid Services recently unveiled proposed new rules that would bar agents from using aggressive tactics such as cold calling, door-to-door selling, and cross-selling of non-healthcare products when pitching Medicare Advantage and Medicare prescription programs. The rules would also block agents from using physicians’ offices and senior citizen centers as marketing venues.

Other proposed regulations would force companies marketing these Medicare plans to use only state-licensed agents and to put together commission schedules that would minimize an agent’s incentive to “churn”—pushing seniors from one plan to another. Critics have charged that some aggressive agents have put seniors into unsuitable plans, causing them to lose their Medicare supplemental coverage or be denied access to their primary care doctors.

The proposed rules have the backing of America’s Health Insurance Plans, the commercial health insurers’ trade group, which had put forward a proposal in March that closely matches the administrations rules. They also have the support of Senator Max Baucus, (D-Montana) chairman of the US Senate Finance Committee, who promised to put the proposed rules into law. Sen. Baucus’ committee is also charged with putting together legislation that would postpone the 10.6% cut in Medicare doctor fees scheduled for July 1.

60%—Percentage of physicians who would limit their number of new Medicare patients if a 10.6% pay cut goes into effect in July.(AMA, 2008)

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