In the wake of last year’s investigation into unfair marketing practices by Medicare HMOs, the Centers for Medicare and Medicaid Services have issued new regulations. (Note: I wrote a commentary that included some observations on Medicare marketing fraud last May).
The new rules include prohibitions on telemarketing and door-to-door sales calls as well as “financial incentives that could encourage agents and brokers to maximize commissions by inappropriately moving, or churning, beneficiaries from one plan to another each year.”
Other specific prohibitions include the following:
“Providing meals to beneficiaries as part of marketing activities;
“Cross-selling of non-health care related products during any sales, marketing, or presentation for an MA [Medicare Advantage] plan or PDP [Prescription Drug Plan];
“Conducting sales presentations or distributing and accepting plan applications in provider offices or other places where health care is delivered; and
“Conducting sales activities, distributing, or collecting applications at education events.”
In addition, CMS plans to triple the number of “secret shoppers,” who are Medicare officials posing as potential enrollees, to monitor health plan marketing activities. Last year, CMS secret shoppers attended 300 Medicare HMO sales and marketing events.
Our comment on all of this? Good.
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