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About 85 percent of private insurers' marketing materials fail to meet all of Medicare's guidelines

05 09 08 - 11:42



Auditors: Drug marketing falls short
By KEVIN FREKING, Associated Press Writer

About 85 percent of the marketing materials that private insurers use for their prescription drug plans fail to meet all of Medicare's guidelines for those products, federal auditors said Thursday.

The marketing products include enrollment applications for the Medicare drug benefit or explanations of a plan's benefits and rules. The Centers for Medicare and Medicaid Services has dozens of requirements for how the information is supposed to be presented to the elderly and disabled. Auditors found that the materials routinely violated one or more of those requirements.


"It's unconscionable that CMS has let the insurance industry's materials including essential items like pharmacy directories and summaries of benefits fail to properly inform seniors 85 percent of the time," said Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee.

A frequent violation was a failure by plans to note that customers could get their prescriptions at a pharmacy other than the one advertised on the marketing product. In some cases, there was no alphabetical index of drugs that a plan covered, potentially hindering beneficiaries' ability to find information about their drugs. Numerous other examples were noted by the inspector general for the Health and Human Services Department.

Medicare officials said they focused their review of marketing materials on elements considered most critical for Medicare recipients to understand, rather than everything in the guidelines. They also said many issues cited by the inspector general "are not atypical during the initial startup of a new program."

The agency has begun to put into place necessary safeguards to ensure marketing materials are reviewed consistently, acting administrator Kerry Weems said.

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