Medicare Advantage Marketing Practices
The OIG recently issued a report entitled “Beneficiaries Remain Vulnerable to Sales Agents’ Marketing of Medicare Advantage Plans.” The report assesses MA plan sponsor compliance with CMS regulations implementing the marketing activity restrictions enacted in the Medicare Improvements for Patient and Providers Act of 2008. Each of six selected plan sponsors reviewed by the OIG did not follow at least one of the marketing regulations concerning sales agent compensation and qualifications. For instance, five of the plan sponsors employing independent sales agents had compensation practices that resulted in inappropriate financial incentives for sales agents and field marketing organizations, and five of the plans did not ensure that all of their sales agents were qualified under CMS’s regulations. The OIG made a series of recommendations, including following-up on noncompliance documented by the OIG, auditing plan sponsors, and strengthening regulatory requirements and CMS guidance in this area.
