Questions have been raised about complaints that some Medicare Advantage (MA) org. and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate info. about covered benefits and conducting prohibited marketing practices. The Centers for Medicare and Medicaid Services (CMS) is responsible for oversight of MA org. and their plans. This report examined: (1) the extent to which CMS has taken compliance and enforcement actions; (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered; and (3) info. CMS has about the extent of inappropriate marketing. Charts and tables.

Today, almost 4 million Medicare beneficiaries have opted for HMOs. Although HMOs must cover the benefits available under traditional fee-for-service Medicare, they differ from one another in the provision of additional benefits, required premiums, networks of providers, & ability to satisfy members. Beneficiaries need information to pick the plan right for them. This report reviews issues in marketing & enrollment for HMO serving Medicare beneficiaries & information that could be made available to assist beneficiaries in choosing an HMO.