The Biden administration has introduced new regulations that prohibit misleading Medicare Advantage advertisements. On Wednesdays, the US Health Department, via the Centers for Medicare and Medicaid Services (CMS), passed a rule that outlaws ads that do not mention specific plan names and misuse Medicare logos or language in a way that misleads participants into believing the advertisements come from the government.
This move comes as part of the Biden administration's efforts to revitalize the Medicare Advantage program, which has gained popularity with half of Medicare beneficiaries enrolling in these plans offered by private, government-approved companies. According to CMS, the concerns stem from the excessive use of Medicare-themed TV advertisements promoting enrollment for Medicare Advantage plans provided by private, Medicare-approved entities.
Becerra, the US Health Secretary, announced the new rule, stating that it would ban deceptive marketing plans from insurance companies offering Medicare Advantage plans and Part D drug plans, along with their affiliates. The regulation will also forbid any marketing ads that confuse or mislead individuals who are eligible to apply for some of these insurance plans.
Becerra mentioned that around 65 million Americans are insured by Medicare. According to him, any advertising that does not explicitly mention the insurance plan and incorrectly represents the benefits it might offer will now be prohibited. This change in regulations is important because it often results in confusion, as many beneficiaries frequently change their plans. Becerra added that alterations could negatively impact their access to healthcare services, which is a concern the administration aims to address.
Last year, the Senate Finance Committee published a report highlighting the increase in deceptive marketing practices targeting Medicare Advantage and Part D beneficiaries. The report also suggested CMS take action to reduce the spread of such marketing tactics.
In addition to marketing requirements, the new regulation clarifies standard guidelines to ensure that people with Medicare Advantage receive the same "medically necessary" care as with traditional Medicare. The regulation also expands the list of individuals for whom Medicare Advantage organizations must provide culturally competent services, such as individuals with limited English-speaking skills or the LGBTQ community. Moreover, the new rule requires Medicare Advantage organizations to maintain the previous approval of palliative care services as long as it is "medically necessary" to prevent care breaks for recipients.
Furthermore, the CMS administrator plans to introduce new minimum standards for behavioral health services for most types of Medicare Advantage plans.
The American Hospital Association welcomed the increasing popularity of Advantage Programs, acknowledging potential challenges in accessing medically necessary treatment for plan beneficiaries.
Tami Luhby, CNN contributor, reported on the new regulation, which aims to protect patients by granting them timely access to healthcare services and reducing excessive administrative burdens for the already stressed healthcare personnel.
