In the fall of 2017, CMS launched the Patients over Paperwork initiative. ( January 1 through March 31 is considered the OEP. Share sensitive information only on official, secure websites. For starters, you must wait until October 1 to market, talk about or review the new plans for the coming year for AEP. Marketing In order to initiate conversations with prospects in person or by phone you will need to have permission to call/contact (PTC). At that time, any new medical sales commissions due will be paid, starting from the first 2023 application. https:// Please contact, on American Progressive Medicare Contracting. hmo6 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. https:// The guidelines allow organizations offering both Medicare Advantage and Prescription Drug Plans the ability to reference one document when developing marketing materials. By: Michelle M. Saavedra The most wonderful time of the year is here! The most recent memo from CMS is available below through the link. In addition, we are also providing clarification to the existing guidance. Medicare Marketing Guidelines | CMS lock Toll Free Call Center: 1-877-696-6775. Medicare 559 0 obj <> endobj 36>=#n!9OB2J{k+ye|8exK2rTx6>#8g-o,.@L [ZGkhyGGGCZ[^;85M L`P83p2@A >(d'X(^`ocTcdPs`/;5Auscv|]B8Uj7g6````>nH "y g` c? A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Manages the alignment of MOAAs The SOA is used to document the type of products you will be discussing once you have a meeting. There is no longer a rule that the SOA needs to be submitted 48 hours prior to the sales appointment. To date, CMS has not released an update or memo for 2021. Federal government websites often end in .gov or .mil. means youve safely connected to the .gov website. a new appointment will need to be made. % Plans may now contact We can expect to see Christmas decorations just about everywhere. endstream endobj 560 0 obj <>>>/Lang( E N - U S)/MarkInfo<>/Metadata 52 0 R/Names 583 0 R/Outlines 643 0 R/OutputIntents 557 0 R/PageLayout/OneColumn/PageMode/UseOutlines/Pages 554 0 R/StructTreeRoot 81 0 R/Type/Catalog/ViewerPreferences<>>> endobj 561 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 43/Tabs/S/Type/Page>> endobj 562 0 obj <>stream Current guidance and model member materials issued by CMS through the Health Plan Management System (HPMS) appear below. Medicaid managed care plans contract with the state Medicaid agency. CMS Updates 2020 Guidelines for Medicare & Medicaid Marketing If you hold or are presenting in a sales event format be sure to follow the rules: Agents are now allowed to have sales event immediately following an educational event. You are able to start taking/submitting applications on October 15th. But how is this fact going to help you sell more health insurance? ) @ 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 Your email address will not be published. This works for health type products only however. AGENT MARKETING GUIDE - Agent Pipeline Ambetter plans to expand access to their value network in Florida. Same day scopes of compliant. It should focus more on promoting your services and general information about Medicare. incorporated into a contract. WebHealth Net Medicare providers can review training and marketing guidelines to ensure services and coverage determinations are accurate. 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. https:// The site is secure. Dental Insurance Commissions The dental commission structure pertains to business with effective dates of 1/1. lock Guidance for Pace marketing guidelines and marketing requirements and related provisions of the Programs of All-inclusive Care for the Elderly (PACE) rules (Chapter 42 of the Code of Federal Regulations (CFR), Part 460 (See Appendix 1 for a list of related laws and regulations). View the Part C EOB materials in the Downloads section below. Because these plansRead more, Free Medicare Lead Program (Turning 65/Med Supplement Leads) NOTE: We have updated our lead program. Make sure to do the scope form prior to starting the meeting however. <>/Metadata 3591 0 R/ViewerPreferences 3592 0 R>> If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov. This plan has been rated 3.5 out of 5 stars. WebMedicare Marketing Guidelines . "N E{8Q*~gc{;Cu6c8CVjm/i~e?]3t1. H\n@yL. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Marketing Models, Standard Documents, and Educational Material, Agent/Broker Dos and Don'ts - Translated (CY 2023) (ZIP), CY2023 Model Materials - Reissued 12-15-2022 (ZIP), CY2023_Part C_Translated_DSNP_Model_Materials_-_Chinese_and_Spanish (ZIP), Agent/Broker Dos and Don'ts - 9-2022 (PDF), CY_2023_Part C_Translated Model_Materials_Chinese (ZIP), CY_2023_Part C_Translated_Model_Materials_Spanish (ZIP), CY2023 Agent Broker Training Testing Guidelines - Updated 08-03-2022 (DOCX), Agent/Broker Dos & Don'ts - Translated (ZIP), Agent/Broker Dos & Don'ts - 9-2021_ (PDF), CY_2022_Part_C_Translated_Model_Materials_Spanish (ZIP), CY_2022_Part_C_Translated_Model_Materials_Chinese (ZIP), CY 2022 Agent-Broker Training and Testing Guidelines_revised 7-6-2021 (PDF), 2021_Part_C_Translated_Model_Materials_Spanish (ZIP), 2021_Part_C_Translated_Model_Materials_Chinese (ZIP), CY_2021_ MA_and_Section_1876_Cost_Plan_Provider_Directory_Model_7-08-2020 (PDF), 2021_Agent_Broker_Training_Guidelines_Revised (DOCX), 2020 Translated Part C Model Materials_Spanish 2 (ZIP), 2020 Translated Provider Directory Models (ZIP), 2020 Agent Broker Training Testing Guidelines (PDF), 2019 Model Materials Updated 12-13-18 (ZIP), 2019 Model Materials - Translations (ZIP), 2019 Translated Model Materials_Part C EOC_SPA (ZIP), 2019 Translated Model Materials EOC Chinese (ZIP), 2019 Agent Broker Training Guidelines_Revised 08.20.18 (PDF), 2018 Model Materials - Translations (ZIP), 2017 Model Materials - Translations (ZIP), 2015 Model Materials - Translations (ZIP). Secure .gov websites use HTTPSA WebCMS COVID-19 Reporting Requirements for Nursing Homes June 2021 [PDF 300 KB] CMS Press Release: CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 [PDF 400 KB] CDC and CMS Issue Joint Reminder on NHSN Reporting 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). They are educational events, Medical Insurance Commissions Medical commissions apply to all metal The Department may not cite, use, or rely on any guidance that is not posted 422.2264: Beneficiary contact. An official website of the United States government. 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 They cannot include plan specific information and cannot be intended to steer someone towards a specific plan. %PDF-1.6 % You also need a scope for phone meetings and virtual meetings. U.S. Department of Health & Human Services Only light snacks and refreshments. You need a scope for any type of sales event. Download the Guidance Document Final Stay away from using any absolute statements on materials or during presentations. Share sensitive information only on official, secure websites. lock X;/?~I(A@%EOMG1Rc9 5:E[0n8 The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription t18:14Xw8zxs zCW`W- d%c@4F&4VXL`w dPO[ I)i61e$EI 2f=!z6"lqr hb```a``Zk @16, TX3 You can decide how often to receive updates. Medicare Advantage Marketing: Understanding CMS Guideline Even for events held by phone only. and which has been designated by CMS as meeting the requirements of an MA SNP as WebMarketing rules for Medicare plans People representing Medicare plans aren't allowed to: Ask for your personal information (like your Medicare, Social Security, bank account, or credit card numbers) over the phone unless its needed to verify membership, determine enrollment eligibility, or process an enrollment request. 219 0 obj <>stream Cano Health Medical Centers Centrum Medical Center Fox Medical Center IMC Health Medical Centers MedFlorida Medical Center UniVida Medical Center Community Medical Group is currently the main provider for the Ambetter Value Network. We provide agents with their own compliant website through Connect4Medicare. Any website CMS considered marketing must be submitted for review and approval through the Health Plan Management System (HPMS). Crowe and Associates offers a free Medicare lead program. Agents and brokers must record all calls (inbound and outbound calls) in their entirety, including calls to inform or educate clients about the event, as well as any post-event discussions. The site is specific and codded to you the agent. hbbd```b``"@$c*dHR0,f@0y,"IK 6w % $fk00120 FIGG Director, Medicare Drug Benefit and C & D Data Group. .gov endstream endobj 160 0 obj <>>> endobj 161 0 obj <. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. Take a look for yourself below. Medicare Marketing Guidelines 2021: Types of events and appointments Meetings and presentation fall under one of three categories. 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). You can decide how often to receive updates. ) Any information we provide is limited to those plans we do offer in your area. How Agents Influence Medicare Beneficiaries Plan Choices <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 13 0 R 16 0 R 17 0 R 21 0 R 22 0 R 28 0 R 30 0 R 33 0 R 34 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 44 0 R 45 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Official websites use .govA The consumer must also know if the plan is considered an low performing plan. The purpose of the SOA is to ensure you will not be discussing products with the client/prospect other than those chosen prior to the appointment. This section includes standardized outreach and educational material for Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost Plans. Medical commissions will be paid for up to four children on the plan. If the materials are not generic in nature they will be considered marketing and require CMS review. The key focus of being of patients over the CMS requirements on the healthcare industry. An official website of the United States government website belongs to an official government organization in the United States. 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 authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically In other words, if you are talking Medicare with someone get a scope. Sign up to get the latest information about your choice of CMS topics. CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE. 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. ) .gov endobj Sign up to get the latest information about your choice of CMS topics. Medicare Communications and Marketing Guidelines 0 means youve safely connected to the .gov website. hbbd``b`>$ &$ .+ bX1 $"pH, $")s@Lz@`!3u>0 '` lock  5 Toll Free Call Center: 1-877-696-6775. ) or endstream endobj startxref Sales made during an Open Enrollment or a Special Enrollment Period are eligible. Communication materials do not require CMS approval. %%EOF hb```b``c`e` B@1V @C Among the salient points: Medicare Advantage Organizations are responsible for first tier, downstream or related entities (FDRs) adherence to all terms and conditions of the organizations contract with CMS Agents are still not able to make unsolicited contact to prospects for MA, MAPD or PDP by phone or in person in common areas. CMS %PDF-1.7 % 159 0 obj <> endobj <> Most people who write articles haveRead more, Your email address will not be published. American Progressive Medicare Contracting American Progressive Medicare Contracting: American Progressive will be offering 3 new plans in NY for 2016 in Westchester, Putnam, Dutchess and Ulster counties. 189 0 obj <>/Filter/FlateDecode/ID[<731268243A464E09A5CB70A201055789>]/Index[159 61]/Info 158 0 R/Length 118/Prev 733811/Root 160 0 R/Size 220/Type/XRef/W[1 2 1]>>stream Hosting a Compliant Medicare Educational %PDF-1.7 endstream endobj startxref If you are showing plan specific details such as benefits or premiums you are engaging in a sales event. or
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