In MA and Part D Marketing, Here's What Not to Say

By James Gutman - April 20, 2012 If Medicare Advantage plans sometimes wonder why CMS puts so much emphasis on marketing surveillance and compliance, they may have gotten the answer in a presentation by a CMS official at the agency's 2012 MA and Part D spring conference in Hunt Valley, Md., April 12. CMS's "secret shopping" during last fall's Annual Election Period for 2012 turned up some statements by plan representatives that might be enough to make anybody wonder, "What were they thinking?" Specifically, as outlined by Christine Reinhard, an attorney in CMS's Division of Surveillance, Compliance and Marketing within the Medicare Drug & Health Contract Group, first there were the inaccurate statements such as "a 3.5 [star] rating is excellent," "there are no five-star plans" and "we have 3.5 stars, but most plans only have two stars." Then there are what she called "inappropriate statements," such as "I don't know how long you'll have a choice," "original Medicare is a disaster" and "you can't win with CMS." Said Reinhard of the last statement: "That one I take a little personally." Beyond that, there were what Reinhard called "scare tactics." Among the examples she cited was the statement, "If other plans have a zero-dollar copay, they will get their money somewhere...[perhaps] cut the number of hospitals...authorization for all medical tests...not letting your doctor make the decision." Imagine the impact on seniors, many of whom have major health problems and understandably are not knowledgeable about Medicare to begin with, as Reinhard noted. How do these kinds of statements get made by plan representatives? What should be done by the plans themselves to make sure their marketers don't cross into these areas? Are there some basic scruples and common sense missing here?