Rule would limit insurers’ pitches

WASHINGTON – Agents selling private health insurance plans to the elderly and disabled would be barred from cold-calling, door-to-door solicitations and pitching their products outside hospital waiting rooms or pharmacies, under a federal rule proposed Thursday.

The rule is designed to make it harder to pressure Medicare beneficiaries into signing up for insurance products they don’t need or want. It essentially restricts face-to-face solicitations to those initiated by the customer.

A new Medicare drug benefit began Jan. 1, 2006. Since then, participants and state insurance commissioners have complained that some agents use false information to enroll people into certain plans, particularly those offering comprehensive health insurance.

“We want to make sure that beneficiaries aren’t pressured into sales,” said Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services.

“In parking lots, waiting rooms and those kinds of places, a salesman can create a pressure environment or a threatening environment where a beneficiary will agree to anything just to get away.”

During congressional hearings, lawmakers urged the Bush administration to curb abusive marketing practices. The rule is unlikely to stop lawmakers’ efforts to give states more authority to hold insurers accountable.

About 27 million people get coverage for their prescription drug needs either through a private insurance plan that offers only the drug benefit or through a “Medicare Advantage” plan that offers comprehensive health benefits. In some cases, people were enrolled in plans even after they made it clear they didn’t want the product.

Advocacy groups said the rule is a step in the right direction, but it won’t be enough. They want states to regulate the insurance companies that offer Medicare Advantage plans. Currently, states only regulate the activities of the agents selling the plans.