JEFFERSON CITY - Insurance companies would face tougher state rules in selling Medicare to the elderly under a measure presented to the Senate Small Business, Insurance and Industry committee Tuesday.

Catherine Edwards of Area Agency on Aging testified that the bill was a matter of equity and fairness to Missouri seniors. Edwards noted that in today's economic climate, the elderly are under more financial pressure than usual. "Every dollar must stretch as far as it can for Missouri seniors," she said.

The measure would enforce existing guidelines for Medicare sales practices. It would also allow seniors to receive a refund for part of their long-term insurance policies and Medicare supplement policies premiums.

Sen. Norma Champion, R-Springfield, is sponsoring the bill brought by the Missouri Department of Insurance.

The bill has two main objectives, Champion said. While many insurance companies already refund any prepaid premiums upon cancellation, the bill would mandate such action for Medicare supplement policies and any long-term insurance policies. Seniors often tend to want to pay their premiums ahead of time, Champion said.

The second, and potentially more contentious, issue involves adopting sales practice guidelines, including those from the Centers for Medicare and Medicaid  Services (CMS). The bill deems a number of trade practices unfair such as cold lead advertising -- also known as 'cold calling' -- and door-to-door soliciting. Insurance sellers are also not allowed to use an appointment made for Medicare sales to discuss other kinds of insurance, such as life insurance or health insurance.

Champion personally testified to receiving a high volume of mailers, some even advertising that they're concerning the recipient's Medicare. "It's very confusing," she said. 

The Department of Insurance has an existing set of guidelines for insurance companies pertaining to unfair sales practices, Angela Nelson, Consumer Affairs Division of the Department of Insurance, testified. Despite these efforts, however, abuse continues. As a result, the insurance department is asking the government to enforce these guidelines.

These practices, together with CMS's marketing guidelines, would be enforced under the bill through suspensions and/or fines, Nelson said.

Shannon Cooper, a lobbyist for America's Health Insurance Plans, testified in opposition to the bill. He cautioned the committee that following the CMS's guidelines from the federal level may cause tension on the state level.Past CMS regulations have contained inconsistencies, Cooper said.

Some members of the committee echoed Cooper's sentiments. Sen. Jason Crowell, R-Cape Girardeau, questioned codifying federal guidelines. He wanted more information on the specifics of the CMS's guidelines.