Date: May 10, 2023 To: Medicare Advantage Organizations, Medicare Advantage-Prescription Drug Plans, Prescription Drug Plan Sponsors, and Section 1876 Cost Plans From: Kathryn A. Coleman, Director Subject: Definition of Marketing 📑 Download the official announcement In order to ensure Medicare beneficiaries are making enrollment decisions based on up-to-date and accurate information, the Centers for Medicare & Medicaid Services (CMS) is issuing this memo to clarify the definition of marketing for Medicare Advantage-Prescription Drug Plans, stand-alone Prescription Drug Plans, 1876 Cost Plans, and Third-Party Marketing Organizations (TPMOs). Regulations at 42 CFR §§ 422.2260 and 423.2260 define marketing as communication materials and activities which meet specific intent and content standards.
To date, CMS has permitted the mentioning of widely available benefits (i.e., vision, dental, premium reduction, and hearing) in materials or activities without those materials or activities being considered marketing subject to the marketing regulations. We did not believe the general descriptions were made with sufficient intent to draw attention to a particular plan or subset of plans. This interpretation was predicated on the assumption that a beneficiary would be unlikely to make an enrollment decision based on widely offered benefits advertised without information on the associated costs for enrollees. CMS monitors both organization and TPMO marketing by reviewing marketing and communication materials and activities, reviewing complaints received through 1-800-Medicare, and listening to marketing and enrollment calls. Due primarily to the recent proliferation of TPMO advertising, we have found, however, through our surveillance, reviews, and discussions with interested parties that many beneficiaries do inquire and some enroll based on the original advertisement of these types of benefits. Beneficiaries have contacted agents, made calls to 1-800 numbers, and responded to flyers asking about the dental, vision, hearing, and cost-savings being marketed. Therefore, we are expanding our interpretation of the regulatory definition of “marketing” to include content that mentions any type of benefit covered by the plan and is intended to draw a beneficiary's attention to plan or plans, influence a beneficiary's decision-making process when selecting a plan, or influence a beneficiary's decision to stay enrolled in a plan (that is, retention-based marketing) and thus subject to review. As stated above, marketing requires both intent and content. Content that beneficiaries can receive benefits such as dental, vision, cost-savings, and/or hearing services is sufficient information about plan benefits, benefits structure or cost sharing to meet the content standard in the definition of marketing in §§ 422.2260 and 423.2260. Further, the use of these statements in advertisements and activities directed to Medicare beneficiaries clearly meets the intent standard. Therefore, beginning July 10, 2023, any material or activity that is distributed via any means (e.g., mailing, television, social media, etc.) that mentions any benefit will be considered marketing and must be submitted into HPMS. This clarification, along with the new marketing safeguards codified in the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly final rule (CMS-4201-F), will help ensure that beneficiaries have accurate information when shopping for Medicare coverage and are protected from potentially misleading marketing activities. Questions may be sent to marketing@cms.hhs.gov. Please copy your Marketing Reviewer. |
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CMS Memo: Definition of Marketing
Posted by www.psmbrokerage.com Admin on Mon, May 15, 2023 @ 11:24 AM
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Tags: CMS, Compliance, Marketing
Avoid These 5 Common Compliance Mistakes
Posted by www.psmbrokerage.com Admin on Thu, May 11, 2023 @ 10:20 AM
Here are five common mistakes and what you can do to remain in compliance with the Centers for Medicare and Medicaid Services (CMS) when working with Medicare beneficiaries on their coverage.
In this industry, we’re busy year-round, and unintentional mistakes can always happen. It’s important to stay on top of the application process and to know exactly what’s needed to remain compliant as we do business. |
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Tags: Compliance
Important Notice For Agents Conducting Telephonic Enrollments
Posted by www.psmbrokerage.com Admin on Wed, Mar 22, 2023 @ 02:43 PM
Important Notice It is essential that agents are aware of CMS and Carrier expectations when conducting telephonic enrollments. Doing so not only protects the client, but also protects the agent from corrective action. Please review the information below and ensure these elements are covered during a telephonic sale to remain compliant and to protect clients.
Agent Must: Complete the SOB (Summary of Benefits) per approved script requirement.
Agent Must: Read all relevant disclosures as outlined in CMS approved script (i.e., verbally or via IVR(INTERACTIVE VOICE RESPONSE)) and collect agreement/understanding. This will include disclosures listed in the application (i.e.: pop up, required statements)
Agent Must: Provide the plan name
Agent Must: Provide carrier name and customer service phone number
Current enrollment
Thank you for your continued support in upholding compliant sales practices! If you have any questions regarding this information, please contact us. |
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Tags: Medicare Advantage, phone sales, Telesales, Compliance
Call Recording Made Simple: Introducing Dialpad
Posted by www.psmbrokerage.com Admin on Wed, Nov 02, 2022 @ 05:06 PM
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Tags: AEP, YourMedicare, Compliance, call recording
PSM Guide: Understanding the New CMS Call Recording Changes
Posted by www.psmbrokerage.com Admin on Wed, Nov 02, 2022 @ 05:05 PM
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Tags: closing sales, Success Tips, CMS, sales advice, Sales Strategies, Compliance
CMS Monitoring Activities and Best Practices during the Annual Election Period
Posted by www.psmbrokerage.com Admin on Thu, Oct 20, 2022 @ 01:33 PM
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Tags: closing sales, Success Tips, CMS, sales advice, Sales Strategies, Compliance
New YourMedicare SunFire Recording Capabilities are Live!
Posted by www.psmbrokerage.com Admin on Fri, Oct 14, 2022 @ 02:58 PM
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Tags: AEP, YourMedicare, Compliance
Avoid CTM Filings - Compliance Bulletin
Posted by www.psmbrokerage.com Admin on Tue, Oct 04, 2022 @ 04:23 PM
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Tags: AEP, YourMedicare, Compliance
YourMedicare SunFire Daily Webinars
Posted by www.psmbrokerage.com Admin on Wed, Sep 28, 2022 @ 10:24 AM
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Tags: Medicare Advantage, AEP, SunFireMatrix, Compliance, MyMedicareBot, call recording
Sunfire: Telephony System is LIVE!
Posted by www.psmbrokerage.com Admin on Fri, Sep 23, 2022 @ 09:56 AM
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Tags: Medicare Advantage, CMS, AEP, SunFireMatrix, Compliance, 2023