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I do think I heard a small cheer from local Medicare Marketers across the country after CMS issued a two-page memo on Oct. 8 reminding (warning?) Medicare Advantage organizations about their obligation when using third-party marketers for lead generation.

The memo felt like a clear shot across the bow to those companies perpetrating what I and other responsible marketers regard as examples of the worst kind of Medicare advertising. 

Excerpt from the full CMS memo:

CMS is particularly concerned with national advertisements promoting MA plan benefits and cost savings, which are only available in limited service areas or for limited groups of enrollees, as well as using words and imagery that may confuse beneficiaries or cause them to believe the advertisement is coming directly from the government

Anyone in the business knows exactly who the memo was aimed at — the Medicare Helpline TV ads featuring retired sports and sitcom celebrities — as well as others (and there are others!) that adopted the same misleading techniques.

But after a momentary celebration, reality quickly set in. And the questions began ...

Why wasn’t the memo issued sooner? These ads have been running for a long while.

The memo issued on Oct. 8 was already eight days into the official AEP marketing season and just seven days before consumers can enroll. The timing seems a little late to make a difference during this AEP.

But wait — the spots look like they have been modified. Is this the third-party marketers’ response to CMS’s concern?

Viewing the most recent ads, you’ll note that minor changes have been made. One spokesman now states: “’depending on your zip code’ you can get the Medicare benefit that adds money to your Social Security check.” These Medicare Helpline modified TV ads began running in the summer and continue to run.

Interestingly, other third-party marketers are also adopting nearly verbatim zip code language. So, I think it is safe to assume CMS warned these organizations earlier in the year and this “wink and a nod” response to add the zip code qualifier is what these marketers are hoping is appropriate to satisfy CMS’s requirement of:

… Medicare Advantage (MA) plans may not mislead, confuse, or provide materially inaccurate information to current or potential enrollees, pursuant to 42 CFR 422.2262.

Will it work? Who knows? It doesn’t appear that any of these ads have been filed with CMS. Or so it would seem, given there’s no CMS code on the spots (another apparent violation of CMS’s guidelines).

So, what do all of us working with or inside the “Solid Citizen” CMS-abiding Medicare Advantage Organizations do?

5 Steps to take right now

While we all wait to see if CMS will take any real action against the national plans that participate with these particular third-party marketers, we recommend the following:

1. Don’t trust third-party marketers to change their ways. Follow up with any disenrolling members. it can all be confusing for Medicare shoppers, especially when they call into one of these 800# hotlines. Plans we work with know, and it seems CMS knows based on how their memo states …

... In addition, CMS receives complaints from beneficiaries and caregivers that highlight sales tactics designed to rush or push beneficiaries into enrolling into a plan)

...  that many consumers did not realize what they were agreeing to when speaking with the third-party marketer’s representative.

Follow-up with any of your members who disenrolled — with an email and/or direct mail to confirm their decision. Let them know that their benefits will be ending. And give them a special member services number to call if they didn’t mean to switch. From marketplace experience, we know this works for saving and retaining members.

2. Consider an outreach to members. Warn them to be careful about who they provide their Medicare information to and remind them of their rights. Add this information in a prominent place on your member website pages and portal.

3. Encourage members to speak out. Let members who have been wrongly switched know they are able to to file a formal complaint with CMS.

4. Oversee third-party marketers. If you use one of these organizations (and some are good partners), make sure they are abiding by all the CMS guidelines. You’ll sleep better at night.

5. Lastly, keep the pressure on CMS. Warnings are nice, but specific penalties are better.

Medicare marketing keeps changing all the time. DMW has helped scores of local and regional plans stay on top of events, 65+ consumer marketing and all relevant compliance trends to meet and exceed their marketing goals. Wondering if your plan could benefit from a new perspective from an agency steeped in Medicare direct response marketing? Contact us for a no-obligation consultation.