Biden Admin Finalizes Rule To Crack Down Deceptive Medicare Advantage Advertising

On Wednesday, the U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, finalized the rule to strengthen Medicare, expand access to behavioral health care, and crack down on "misleading" advertisements.
The Department of Health and Human Services rule targets private insurers that offer the so-called Medicare Advantage plans, which have been soaring in popularity.
According to CMS, the "proliferation of certain television advertisements" promoting enrollment in Medicare Advantage plans – offered by Medicare-approved private companies – has been concerning.
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The final rule applies to coverage beginning January 1, 2024.
The rule will crack down on misleading marketing schemes by the health insurance companies offering Medicare Advantage plans Part D prescription drug plans and their downstream entities.
Among other provisions, the rule would prohibit overly general ads about the Medicare Advantage program that often tends to confuse and mislead individuals.
Further, the final rule strengthens accountability for plans to monitor agent and broker activity.
In general, about 65 million Americans are in the Medicare program.
CMS is also finalizing behavioral health and primary care service wait time standards.
In addition, CMS requires most types of Medicare Advantage plans to include behavioral health services in care coordination programs.
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