Senator Looks Into Deceptive Marketing by Medicare Advantage Plans

Senate Finance Committee Chair Ron Wyden (D-Ore.) has inquired about potentially deceptive marketing practices by Medicare Advantage plans that exploit seniors and people with disabilities. 

Wyden sent letters to 15 state insurance commissioners and state health insurance assistance programs requesting information on Medicare Advantage and Part D plans.

The Senate Committee on Finance has jurisdiction over health plans under the Social Security Act; thus, Wyden is responsible for Senate oversight of Medicare Advantage and Part D drug plans.

The concern comes as CMS has reported an increase in Medicare Advantage beneficiary complaints. In addition, Wyden said he had heard reports that Medicare Advantage and Part D plans were engaging in aggressive sales tactics and promoting misleading advertisements that harm seniors and people with disabilities.

The letter referenced a 2010 report from the US Department of Health and Human Services Office of the Inspector General (HHS OIG) which found that marketing complaints about Medicare Advantage plans persisted even after the implementation of sales agent marketing regulations.

The letter included 11 questions to which Wyden requested responses by September 16.

Wyden asked the state insurance commissioners how many complaints they have received about Medicare Advantage or Part D plans in 2019, 2020, 2021, and 2022 and for their offices to divide the complaints by Third-Party Marketing Organization (TPMO).

The letter requested examples of potentially false or misleading marketing materials or advertisements, including mailers, robo-calls, television commercials, websites, and online advertisements.

Wyden asked that the programs submit quantitative and qualitative data on any differences in reports of complaints among groups of Medicare beneficiaries, such as lower-income, dual eligible, or Black or Hispanic beneficiaries.

In addition, he inquired whether complaints were typically related to certain product aspects, such as provider networks, cost-sharing, premiums, or supplemental benefits.

Wyden sought information on marketing materials making false comparisons between Medicare Advantage and Medicare Supplemental Insurance products, trends in complaints of unsolicited beneficiary contact, and organizations that account for a disproportionate share of complaints.

Finally, the letter asked commissioners if there are parent organizations, TPMOs, or other market participants that have provided false or misleading marketing materials.

The following states received a letter from Wyden: Arizona, California, Colorado, Florida, Georgia, Illinois, Massachusetts, Michigan, Missouri, New York, North Carolina, Ohio, Oregon, Pennsylvania, and Texas.

In a response to Wyden’s letter, Better Medicare Alliance defended the Medicare Advantage program.

“Medicare Advantage plans’ marketing materials are already subject to careful regulation: they must be approved by CMS and are answerable to more than 50 pages of federal guidelines. With a 94 percent consumer satisfaction rate, it is clear that this program consistently lives up to its promise for seniors,” Mary Beth Donahue, president and chief executive officer of the Better Medicare Alliance, said. 

“A full accounting of the facts will show what seniors have been telling us all along: Medicare Advantage, with its lower costs, added benefits, and improved health outcomes, delivers a better consumer experience that deserves continued support and protection.”

“Policymakers must take action to modernize Medicare enrollment in ways that offer more transparency in coverage choices and empower consumers, rather than criticizing those standing in the gap to help beneficiaries navigate this difficult and complicated process,” Donahue continued.

The response also stressed that enrolling in Medicare Advantage is an active choice and it is illegal to enroll a beneficiary in Medicare Advantage without their knowledge or consent.

Additional data from Better Medicare Alliance found that Medicare Advantage plans accounted for 50 percent or more of Medicare enrollment in 123 congressional districts. Similarly, more than 30 states had more than 40 percent of their Medicare beneficiaries covered by Medicare Advantage plans.

Recent data from JD Power revealed that Medicare Advantage member satisfaction increased by three points between 2021 and 2022 and 15 points over the last five years.