COMPLAINTS SPIKE ABOUT MEDICARE ADVANTAGE — A steep spike in complaints from older adults over the marketing of Medicare Advantage plans has the attention of top Democrats on Capitol Hill, Megan reports. Last year, beneficiaries made nearly 40,000 complaints related to the marketing of private Medicare Advantage plans — up from just 15,500 in 2020, according to the Centers for Medicare and Medicaid Services. The backstory: Medicare Advantage enrollment is now up to almost half of all Medicare beneficiaries this year, compared with 33 percent five years ago. The plans can be less expensive than traditional Medicare, in addition to providing supplemental benefits like vision and hearing and offering more coordinated care. The booming market is also lucrative for insurance companies and the people — usually licensed agents but sometimes less regulated companies — who receive commissions and other payments for enrolling beneficiaries. What older adults are saying: The growing body of complaints falls under the category “marketing misrepresentation.” The agency declined to provide detailed information about the complaints, saying that its database “contains limited information” on each one. But in a rulemaking earlier this year, CMS said many complaints appear to stem from the actions of third-party marketing organizations. Those who call to learn more about the advertised benefits aren’t always certain who they’re speaking with, what plans the marketing organizations represent or whether they’re signing up for a new plan during the call, CMS said earlier this year in a rule designed to tighten marketing regulations. Who’s looking into it: Senate Finance Chair Ron Wyden (D-Ore.) is investigating the complaints, soliciting information from state insurance commissioners detailing instances of false or misleading marketing and its impact on older adults. WHILE WE’RE ON THE SUBJECT … A new Kaiser Family Foundation review of 62 published studies found that Medicare and Medicare Advantage plans don’t have many substantial differences, with enrollees for both reporting “similar rates of satisfaction with their care and overall measures of care coordination.” Medicare Advantage plans came out ahead in a few areas, including use of preventive services, access to a usual source of care and lower hospital readmission rates. But traditional Medicare outperformed the private plans when it came to receiving care in the highest-rated hospitals for cancer care, the highest-quality skilled nursing facilities and home health agencies. AND MEDICARE PATIENTS EMBRACE TELEHEALTH — A new study published in JAMA Health Forum found Medicare patients took advantage of pandemic-era policies permitting them to see doctors who practice in other states via phone or video call, POLITICO’s Ben Leonard reports. Most of the visits with out-of-state clinicians were for primary and mental health care. Rural patients, as well as those living near state borders or seeking cancer treatment, were especially likely to seek care across state lines. The current landscape: Amid the Covid-19 pandemic, many states eased restrictions that limited patients’ access to virtual visits with providers in different states. Those waivers have largely ended, leaving a patchwork of state policies that can confuse patients and providers. What’s next: HHS Secretary Xavier Becerra has called on Congress to pass legislation permitting cross-state visits, but even stakeholders disagree on what to do now that the state waivers are ending. The American Medical Association, which represents doctors, and state medical boards favor the Interstate Medical Licensure Compact that many states have joined. It makes applying for licensing across state lines easier by serving as a common application. The telehealth industry is divided on how to tackle the issue, but some argue in favor of a licensing system similar to that for drivers, in which states accept each other’s licenses.
| 
