In a strongly worded letter to the Centers for Medicare & Medicaid Services and the Federal Trade Commission, four patient advocacy groups are seeking urgent action to address UnitedHealthcare’s “misleading advertising” directed at low-income Connecticut residents who are dually eligible for Medicare and Medicaid. The letter alleges that the advertisements “fraudulently induce these vulnerable individuals” to enroll in United’s Medicare Advantage plans.
The advertisements at issue offer extra benefits not covered under traditional Medicare. The letter points out, however, that most of the “extra” benefits are actually already available to Medicaid beneficiaries in Connecticut. The letter also points out that the advertisements fail to disclose that individuals enrolling in United’s Medicare Advantage plans have a smaller network of providers than under traditional Medicare and will be subject to excessive prior authorization requests “making access difficult particularly for expensive kinds of healthcare.”
The letter concludes by stating that the “unchecked misleading advertising inducing vulnerable disabled and older dual eligible individuals to sign up for these plans, which then significantly harms their access to essential health care, has gone on long enough” and asks CMS and the FTC, intra alia, to fine United and bar it from further direct advertising in Connecticut.
The organizations signing the letter are the Center for Medicare Advocacy, the National Disability Rights Network. The National Health Law Program and Disability Rights Connecticut. The letter is linked here.
Provider groups have also recently written to CMS complaining that United and other Medicare Advantage plans have adopted policies that violate new Medicare Advantage rules governing medical necessity determinations for inpatient admission and other services.
Whatley Kallas, LLP’s recent article on the American Hospital Association and the Federation of American Hospitals’ letter to CMS regarding Medicare Advantage plan policies is linked here.