Democratic Lawmakers To Propose Restrictions On Private Medicare Advantage Plan

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Private Medicare Advantage Plan

Democraticlawmakers are developing legislation that would prohibit certain marketing practicesused by private Medicare Advantage plans after some seniors complained ofaggressive sales tactics, the AP/SanJose Mercury News reports. Although the Bush administration has imposed some new regulationson MA plan marketing over the past year, Senate FinanceCommittee Chair MaxBaucus (D-Mont.) said many lawmakers are not satisfied with the results.

The Bush administration has required some private MA plans to callbeneficiaries after they sign up for coverage to ensure they understand thatthey are not enrolled in traditional Medicare. In addition, the administrationhas developed a "secret shopper" program to monitor sales agents'marketing presentations.

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The legislation would ban door-to-door sales of MA plans and prohibit insurersfrom using call centers to find potential sales leads. Carol Guthrie, a Baucusspokesperson, said that another provision of the measure would prohibit agentsfrom representing themselves as being from the Medicare program. In addition,the measure would make it illegal for insurers to pay agents bonuses orcommissions based on the number of new beneficiaries they enroll, according toGuthrie. She said Baucus also wants to give states more power to regulateprivate MA plan marketing practices.

Peter Ashkenaz, a spokesperson for CMS, said the legislation isunnecessary because the practices it targets already are banned throughregulations and contract requirements. In addition, he said the agency hassanctioned insurers whose sales agents have taken advantage of Medicarebeneficiaries. Officials from America's HealthInsurance Planssaid that the trade group would work with the Finance Committee on thelegislation but that the measure is irrelevant because the concerns are alreadycovered by regulations and voluntary guidelines put in place by the industry(Freking, AP/San Jose Mercury News, 2/6).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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