WASHINGTON (AP) – Medicare issued new rules Monday that restrict insurance agents’ contact with the elderly and disabled when selling prescription drug plans and more comprehensive health coverage called Medicare Advantage.

The regulations will go into effect Oct. 1, which is when insurers can begin marketing their plans for 2009. Among the changes mandated by Congress are:

• No unsolicited contacts with beneficiaries, such as visiting their home or calling them. The prospective customer must initiate the contact.

• No selling of other insurance products, such as annuities or life insurance, to beneficiaries.

• No free meals at promotional or sales events.

• New requirements for training or testing of agents.

Lawmakers and the Centers for Medicare and Medicaid Services acted after beneficiaries and advocacy groups complained of high-pressure sales tactics that led some people to sign up for plans that didn’t meet their health care needs. For example, some signed up for plans that didn’t cover their medicines, or required them to change doctors.

Medicare officials said enforcement of the regulations would include more surveillance of insurance agents’ presentations through a “secret shopper” program, as well as a review of a plan’s print and broadcasting ads.

Insurers will also be subject to penalties of up to $25,000 for each enrollee affected or likely to be affected by illegal marketing tactics.

Federal officials recommend that all Medicare enrollees review their drug and insurance coverage going into the new enrollment season, which begins Nov. 15. Plans typically adjust which medicines they’ll cover in the coming year, as well as how much they’ll charge.


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