For Medicare Advantage organizations, agents, brokers, and other stakeholders preparing for this year's marketing season, a new complication has emerged: state insurance regulators are asserting oversight authority that CMS has long treated as exclusively federal, and artificial intelligence tools are further blurring who is accountable for what.
In a recent episode of AHLA's Speaking of Health Law, host Kathy Roe of Health Law Consultancy explored the widening rift between CMS and state departments of insurance over Medicare Advantage marketing oversight with Helaine Fingold, Member of the Firm of Epstein Becker Green and counsel to Medicare Advantage organizations, PACE plans, and other managed care entities on Medicare Advantage compliance, marketing oversight, and program audits, joined by Laurie Poulos, General Counsel and Chief Compliance Officer of TRANZACT.
The conversation traced where the CMS-state conflict currently stands and what it means in practice for Medicare Advantage organizations and the agents and brokers who sell their plans. Helaine and Poulos also discussed CMS's public statements on artificial intelligence in Medicare Advantage marketing and identified where CMS and state regulators may diverge as AI tools become more embedded in enrollment and sales practices. The episode builds on an article Helaine co-authored for AHLA's Health Law Connections magazine, Managed Care, Who Calls the Shots? State and Federal Roles in Medicare Marketing and the Inevitable Power Struggle in Governing AI.
Get in Touch
To discuss how the growing divide between CMS and state insurance regulators may affect your organization's Medicare Advantage marketing compliance and AI governance practices, contact Helaine Fingold at hfingold@ebglaw.com.
People
Member of the Firm