Hardly an advantage

Tuesday, May 13, 2008 | 2:04 a.m.

Under a Bush administration proposal, private Medicare insurance plans no longer would be allowed to hawk policies door to door or engage in other tactics that critics say prey on older Americans.

The new rules would prohibit Medicare Advantage plan agents from approaching people in the parking lots of senior centers, medical clinics and apartment buildings. They also call for a stop to cold-calling senior citizens. Telephone sales pitches could be made only to seniors who have first made an inquiry.

Private insurers have been allowed to administer a private version of Medicare coverage since the late 1990s, ostensibly to allow Medicare beneficiaries to receive better access to medical care in areas where there aren’t enough doctors or where doctors don’t accept traditional government-sponsored Medicare. In return, the federal government pays up to 19 percent more for the medical services offered through these private plans than it pays for services offered through traditional government-funded Medicare.

The New York Times reported last year that agents of Medicare Advantage plans increasingly have engaged in predatory practices, such as enrolling older people in plans without their knowledge.

Currently state insurance commissioners investigate fraudulent Medicare Advantage marketing. But with about 8 million people enrolled in such plans nationally, states often don’t have the resources to pursue many complaints.

The administration’s proposed rules would appear to be an improvement, but there is a catch:

Only the federal government — not the states — would be able to take action against predatory marketing practices. But the federal government doesn’t have adequate resources to police the plans either, Paul Precht, policy director of the Medicare Rights Center, which counsels Medicare beneficiaries, told The New York Times last week. Enforcement, Precht said, needs a joint state-federal approach.

We agree. Relegating this important duty to either the federal government or the states likely will result in little or no enforcement, no matter how strict the rules are. Federal and state officials should work together to ensure that prospective Medicare Advantage recipients are not being preyed upon.