New Marketing Guidance Leaves Too Many Unanswered Questions

Last week, the Medicare Rights Center submitted comments on new federal marketing guidance that will apply to Medicare Advantage (MA) and Part D prescription drug plans in 2019.

The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, updates and releases marketing guidance every year so that MA and drug plans have current, uniform rules for marketing their products safely and accurately, without discriminating against people with Medicare. Some years see minor tweaks to the rules, but other years, like this one, see wholesale changes in how plans may be marketed.

We have significant concerns about next year’s guidance, in part, due to what it fails to address. Starting in 2019, MA plans will have access to new flexibilities that may make the already complex plan selection process even more confusing. One example that we have discussed in the past is a new option for MA plans to offer a wider array of supplemental benefits. This is a brand-new opportunity for plans that will have significant implications for consumers – yet the updated guidelines do not address it at all. In not doing so, CMS has lost a valuable opportunity to establish firm guardrails to protect people with Medicare.

We also believe that the availability of supplemental benefits must not become just a sales tool and sponsors must not be permitted to use them as a marketing device to persuade beneficiaries into their plans. To the contrary, MA plans need guidance on how they can market plans with such benefits without cherry-picking and inappropriately steering potential enrollees.

There are other points throughout the guidance where CMS appears to be easing marketing restrictions that were put in place to protect people with Medicare, and in response to persistent, documented abuses.

It was important for us to respond to this new guidance to inform the development of future guidelines. Our comments register our objections to any changes that may loosen or remove consumer protections, or leave gaps for harmful, misleading, or coercive marketing practices. More and more, people with Medicare need tools to find the right coverage for their individual circumstances. This requires robust oversight to protect beneficiary access to care, economic stability, and well-being.

Read more about supplemental benefits.

Read our comments.

Read the new marketing guidelines.