On March 25, Senate Finance Committee Ranking Member Ron Wyden (D-OR) released a report detailing the committee's investigation into marketing practices by Medicare Advantage (MA) plans and other organizations working with such plans. Following an uptick in consumer complaints about MA marketing practices in 2021 and 2022, then-Chairman Wyden convened a hearing in 2023 focusing on marketing in the MA program and subsequently opened an inquiry into business practices by five third-party marketing organizations (TPMOs). This report details the findings of that inquiry and focuses on MA plans' use of "a secretive network of companies"—including TPMOs and lead generators—to market plans.
The report names three categories of harms from this marketing:
- Creating consumer confusion;
- Increasing Medicare spending overall, including Part B premiums; and
- Causing consumers to enroll in MA plans that do not work well for them.
The report offers several recommendations to lower costs and to improve consumers' experience in enrolling in MA. Among other recommendations, the report proposes that Congress and CMS:
- Prohibit practices that could incentivize enrolling consumers in one plan over another and to more tightly regulate marketers, including through civil and criminal penalties for violating or ignoring CMS requirements;
- Require that agents and brokers act as fiduciaries for MA enrollees;
- Directly regulate TPMOs and lead generators;
- Establish a fixed fee for all MA plan enrollments, including administrative costs; and
- Increase funding for impartial information on enrollment for Medicare beneficiaries, including to State Health Insurance Assistance Programs, Senior Medicare Patrol, 1-800-MEDICARE, and ombudsman programs.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
