CMS Final Rule Tackles Deceptive Marketing and Promotes Cultural and Digital Health Competency in Medicare Advantage

On April 5, the U.S. Department of Health and Human Services(HHS), through the Centers for Medicare and Medicaid Services(CMS), issued a Medicare Advantage rule that, among other things, finalizes 21 marketing provisions to protect beneficiaries from confusing and misleading marketing while also ensuring that they have accurate and necessary information to make coverage choices that best meet their needs.

CMS is prohibiting ads that do not mention a specific plan name as well as ads that use words and imagery that may confuse beneficiaries or use language or Medicare logos in a way that is misleading, confusing, or misrepresents the plan. In the rule, CMS also reinstates important protections that prevent predatory behavior and finalized changes that strengthen the role of plans in monitoring agent and broker activity.

Beyond marketing requirements, the final rule clarifies criteria guidelines to help ensure that people with Medicare Advantage receive access to the same “medically necessary” care they would receive with traditional Medicare. The rule also expands the list of populations to which Medicare Advantage organizations must provide “culturally competent” services, such as people with limited English proficiency or those in the LGBTQ+ community. 

In recognition of the fact that populations that experience health disparities also demonstrate low digital health literacy, CMS is finalizing requirements for Medicare Advantage organizations to develop and maintain procedures to offer digital health education to enrollees to improve access to medically necessary covered telehealth benefits.