Centers for Medicare and Medicaid Services (CMS) issued a final rule

The U.S. Centers for Medicare and Medicaid Services (CMS) issued a final rule on April 5, 2023, revising the regulations governing marketing by Medicare Advantage plans (MAPs) and Medicare Part D plans (PDPs). These changes follow CMS October 2022 memo expressing concern regarding MAP and PDP marketing practices and the proposed rule issued on December 14, 2022. The changes are applicable for all contract year 2024 marketing and communications beginning September 30, 2023.

• advertisements that (1) do not mention a specific plan or (2) use the Medicare name or logo in a misleading way.
• marketing of benefits in a service area where those benefits are not available.
• the use of superlatives (e.g., words like best and most) in marketing unless the material provides documentation to support the statement and the documentation is based on data from the current or prior year.
• Plans must notify enrollees annually in writing of their ability to opt out of phone calls regarding MAP and PDP business.
• Confirmed that the prohibition on door-to-door contact without an appointment still applies after the collection of a business reply card or scope of appointment (SOA).
• SOA cards may not be collected at educational events.
• There must be a 48-hour window between a SOA being completed and an agents meeting with a beneficiary.
• A marketing event may not occur within 12 hours of an educational event at the same location.
• Sales agents may call a potential enrollee no later than 12 months following the date that the enrollee first asked for information.
• Medical benefits must be listed in a specific order at the top of a plans Summary of Benefits.
• Sales, marketing, and enrollment calls between third-party marketing organizations (TPMOs) and beneficiaries must be recorded.
• Third Party Marketing Organizations (TPMO's) must list or mention all of the MAPs or PDP sponsors that they represent on marketing materials.
• Plans must require agents to explain the effect of an enrollees enrollment choice on their current coverage whenever the enrollee makes an enrollment decision.
• Plans must have an oversight plan that monitors agent/broker activities and reports agent/broker noncompliance to CMS.

MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further explanation.