Download the Guidance Document Final Issued by: Centers for Medicare & Medicaid Services (CMS) Issue Date: January 01, 2020 HHS is committed to making its In addition, we are also providing clarification to the existing guidance. The site is secure. This revision replaces Chapter 3, Medicare Marketing Guidelines for Medicare Advantage, Medicare Prescription Drug Plans, Prescription Drug Plans and 1876 Cost plans with a new revised Chapter 3. Toll Free Call Center: 1-877-696-6775. Medicare Marketing Guidelines For Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, Employer/Union-Sponsored Group Health Plans, Medicare-Medicaid Plans, and Section 1876 Cost Plans. View the Part C EOB materials in the Downloads section below. A federal government website managed by the They cannot include plan specific information and cannot be intended to steer someone towards a specific plan. ) An official website of the United States government Same day scopes of compliant. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423). However, the does need to have an opt out option in option to be compliant. An official website of the United States government. website belongs to an official government organization in the United States. https:// While plans may deplete existing hard copy stock, they should add the approval number and expiration date to the online versions and newly produced hard copies by January 1, 2020. January 1 through March 31 is considered the OEP. The federal regulation at 42 CFR 438.104 defines marketing as any communication, from an [Medicaid managed care plan] to a Medicaid beneficiary who is not enrolled in that entity, that can reasonably be interpreted as intended to influence the beneficiary to As part of CMS implementation of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS has revised the Medicare Marketing Chapter to Agents are credited for all enrollments. All Rights Reserved. CMS replaced the models that were previously posted on this website to reflect the OMB approval number and expiration date. Medical Insurance Commissions Medical commissions apply to all metal If the materials are not generic in nature they will be considered marketing and require CMS review. EJ+QTEEJ+QtE mU|9"TavkY pUqF`%l]7 >m! ) Sales events, on the other hand, are designed to steer, or attempt to steer potential enrollees towards a limited set of plans. Before sharing sensitive information, make sure youre on a federal government site. means youve safely connected to the .gov website. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare-Medicaid Plan (MMP) Marketing Information & Resources, List of Covered Drugs - English & Spanish, Provider and Pharmacy Directory - English & Spanish, Medicare-Medicaid Plan (MMP) Application & Annual Requirements, Medicare-Medicaid Plan (MMP) Reporting Requirements, Medicare-Medicaid Plan (MMP) Audit Programs, Medicare-Medicaid Plan (MMP) Encounter Data Reporting, Medicare-Medicaid Plan (MMP) Quality Withhold Methodology & Technical Notes, Medicare-Medicaid Plan (MMP) Chronic Care Improvement Programs & Quality Improvement Projects, CY 2023IllinoisMMP Model Materials Memo (PDF), CY 2023Illinois MMP Marketing Guidance (PDF), CY 2023 MassachusettsMMP Model Materials Memo (PDF), CY 2023Massachusetts MMP Marketing Guidance (PDF), CY 2023 Michigan MMP Model Materials Memo (PDF), CY 2023Michigan MMP Marketing Guidance (PDF), CY 2023Minnesota Plan Model Materials Memo (PDF), CY 2023Minnesota PlanMarketing Guidance (PDF), CY 2023 New York FIDA-IDD MMP Model Materials Memo (PDF), CY 2023New York FIDA-IDD MMP Marketing Guidance (PDF), CY 2023 Ohio MMP Model Materials Memo (PDF), CY 2023Ohio MMP Marketing Guidance (PDF), CY 2023 Rhode Island MMP Model Materials Memo (PDF), CY 2023Rhode Island MMP Marketing Guidance (PDF), CY 2023 South Carolina MMP Model Materials Memo (PDF), CY 2023South Carolina MMP Marketing Guidance (PDF), CY 2023 Texas MMP Model Materials Memo (PDF), CY 2023Texas MMP Marketing Guidance (PDF), Explanation of Benefits - Integrated & Drug-Only, Provider& Pharmacy Directory - English & Spanish, Annual Notice of Change - English & Spanish, Explanation of Benefits (EOB) - Drug Only & Integrated, Annual Notice of Change - English& Spanish, Explanation of Benefits (EOB) - Drug Only, Integrated Coverage Determination Notice (ICDN) Models, Provider & Pharmacy Directory - English & Spanish. The .gov means its official. (SOA) The PTC is used to start contact with a prospect. 3 0 obj SOAs are needed for every face to face meeting. Director, Medicare Drug Benefit and C & D Data Group. This plan has been rated 3.5 out of 5 stars. Marketing Communications Guidelines while the proposed changes noted above are both welcome and necessary, CMS should reverse the significant changes to the guidelines that have weakened protections in recent years, and add new requirements; for example, as noted above, CMS should: Rescind rules weakening marketing v. educational Overall, the holiday season seems to bring joy and family unity around the world. incorporated into a contract. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov. Current guidance and model member materials issued by CMS through the Health Plan Management System (HPMS) appear below. Sign up to get the latest information about your choice of CMS topics. or a new appointment will need to be made. means youve safely connected to the .gov website. CMS requires all marketing websites to be submitted for review. Marketing Guidelines MCS Improving or Maintaining Mental Health MedPAC Medicare Payment Advisory contract year 2021 and 2022. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Marketing Models, Standard Documents, and Educational Material, CY2018MedicareMarketingGuidelines_Final072017 (PDF), CY2019 Medicare Communications and Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.17.14 Updated with Issue Date (ZIP), CY 2016 Medicare Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.28.13 (ZIP). Medical Insurance Commissions Medical commissions apply to all metal levels and plans sold on or off Marketplace. The consumer must also know if the plan is considered an low performing plan. WebThe Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that insurance companies selling plans must follow. You can decide how often to receive updates. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare Communications and Marketing Guidelines 3-16-2022 (PDF), CY 2016 Medicare Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.28.13 (ZIP), CY2018MedicareMarketingGuidelines_Final072017 (PDF), CY2019 Medicare Communications and Marketing Guidelines_Updated 090518 (PDF), Medicare Marketing Guidelines 06.17.14 Updated with Issue Date (ZIP), Medicare Communications & Marketing Guidelines Update Memo - 8-6-19 (PDF), Medicare Advantage Marketing Regulations - 422 Subpart V, Medicare Part D Marketing Regulations - 423 Subpart V. Download the Guidance Document Final Qu4 8q ]8!FaO6{dB>8ws#%=MK%E,E*e*!*O|?Q4RRRRSiRiS]O8kgn^0N.iP~3nOF"FD"yza4={ o?l)$Fq\xH*QDEl IU%QJ(D* Chapter 3. Medicare Marketing Guidelines. In the fall of 2017, CMS launched the Patients over Paperwork initiative. Agents and brokers must record all calls (inbound and outbound calls) in their entirety, including calls to inform or educate clients about the event, as well as any post-event discussions. The difference between the two is the material used and intent of the material. @ If they would like to review non health related products such as life insurance, LTC, annuity, etc. Ambetter plans to expand access to their value network in Florida. website belongs to an official government organization in the United States. endstream endobj startxref Starting January 1, 2023, Ambetter Value plan members can access providers in the below list for all medical needs. SUBJECT: Medicare Communications and Marketing Guidelines . Medicare Advantage Organizations, Prescription Drug Plans, and Section 1876 Cost Plans may rely on the contract year (CY) 2019 Medicare Communications and Marketing Guidelines (MCMG), which can be found at Agility Insurance Services, LLC. PTC can be obtained through flyers, business reply cards, PTC forms online leads (Likes or shares on social media platforms are not valid) from vendors and other methods that prospects use to initiate contact. or Stay away from using any absolute statements on materials or during presentations. Toll Free Call Center: 1-877-696-6775. 200 Independence Avenue, S.W. 4 0 obj For starters, you must wait until October 1 to market, talk about or review the new plans for the coming year for AEP. 422.2264: Beneficiary contact. Are you contracted with Ambetter yet? CLICK HERE TO ACCESS MEDICARE MARKETING CMS MCMG MEMO. endstream endobj startxref Free should also not be included in any description of part B premium, part B reduction plans or dual eligible status. 582 0 obj <>/Filter/FlateDecode/ID[<5F2038F586BEA94FAD73980201E44AA1>]/Index[559 140]/Info 558 0 R/Length 121/Prev 362965/Root 560 0 R/Size 699/Type/XRef/W[1 3 1]>>stream [M7XRM v:rY DXF4UbT+"J%p$ This chapter contains revisions in most of the sections within the manual chapter, however, there are some sections that have not been revised, but are included in this instruction as well. 1 This post will outline two of the moreRead more, Medicare Advantage vs Supplement Plans Sales As you can see in this post, Medicare Advantage vs Supplement Plans Sales have a few differences. If you are showing plan specific details such as benefits or premiums you are engaging in a sales event. %PDF-1.7 Link to recorded webinar https://attendee.gotowebinar.com/recording/2899290519088332033, All agents receive a personalized enrollment website. In addition, they can compare drug plans in a manner similar to the Medicare drug plan finder site. Schedule marketing appointments immediately after the meeting You cannotdo the following: Require anyone to sign on or provide contact information Hand out or take applications or other plan specific information- (This is a marketing event) Give away cash prizes Provide or take enrollment forms Discuss carrier specific information including individuals with disabilities. Even for events held by phone only. Issued by: Centers for Medicare & Medicaid Services (CMS). and which has been designated by CMS as meeting the requirements of an MA SNP as Washington, D.C. 20201 hbbd``b`>$ &$ .+ bX1 $"pH, $")s@Lz@`!3u>0 '` Medicare Marketing Guidelines 2021: Types of events and appointments Meetings and presentation fall under one of three categories. You are able to start taking/submitting applications on October 15th. Secure .gov websites use HTTPSA 559 0 obj <> endobj The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. The key focus of being of patients over the CMS requirements on the healthcare industry. zCW`W- d%c@4F&4VXL`w dPO[ I)i61e$EI 2f=!z6"lqr 0 authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically This means that all marketing materials must be clear, and accurate, and not promote any plans inappropriately. View the Agent/Broker Training & Testing Guidelines in the Downloads section below. It should focus more on promoting your services and general information about Medicare. 0 LEARN WHAT WE HAVE TO OFFER HERE. Meetings and presentation fall under one of three categories. CMS considers communications and marketing to be two different things. Ambetter Value plans are available in: Broward, Clay, Duval, Hillsborough, Lake, Miami-Dade, Orange, Osceola, Palm Beach, Pasco and Seminole counties. Any information we provide is limited to those plans we do offer in your area. We can expect to see Christmas decorations just about everywhere. ( This works for health type products only however. WebThe Centers for Medicare & Medicaid Services (CMS) reminds organizations of critical Medicare Part C and D readiness items prior to the 2020 Annual Election Period (AEP) and lock Communication materials do not require CMS approval. But how is this fact going to help you sell more health insurance? Crowe and Associates offers a free Medicare lead program. ) Agents are still not able to make unsolicited contact to prospects for MA, MAPD or PDP by phone or in person in common areas. Medicare Advantage plans are offered by private insurance companies. Web( 2) The material has been deemed approved; that is, CMS has not rendered a disposition for the material within 45 days (or 10 days if using CMS model or standardized marketing As part of CMS implementation of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS has revised the Medicare Marketing Chapter to include the latest provisions in the current guidance. The agent will be the broker of record on any enrollment. Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423).
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