CMS more precisely defines marketing in relation to Medicare plans.

What's changing with Medicare compliance?

The Centers for Medicare and Medicaid Services (CMS) discovered through complaints and analyses of recorded sales calls that many beneficiaries inquire about and enroll in Medicare plans when they hear about broadly accessible features, such as dental, eye, and hearing care, as well as premium reductions and cost savings.

The CMS definition of Medicare marketing has been updated to include "content that mentions any type of benefit covered by the plan and is intended to draw a beneficiary's attention to a 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)."

Advertisements mentioning generally accessible benefits, such as dental, vision, and hearing benefits, in the past were not regarded as marketing by Medicare Advantage and Part D Prescription Drug Carriers or Third Party Marketing Organizations. Beginning July 10, 2023, any reference to benefits in marketing materials for Medicare Advantage, Part D, and Cost plans will be deemed "marketing" and will need to be submitted to and approved by CMS via HPMS before use.

According to CMS, marketing definitely involves retention marketing. CMS relaxed the call recording mandate from the previous year to simply cover sales, marketing, and enrollment calls in their 2024 Final Rule for Medicare Advantage and Part D Standalone Prescription Drug Plans. Agents will need to record phone or telephone conversations with clients who might be persuaded to stay enrolled in their existing plan because retention marketing is now seen as marketing.

By July 10, 2023, you will no longer be permitted to promote generally accessible benefits in your Medicare Advantage, Part D Prescription Drug Plans, and Cost Plan marketing unless the materials have been submitted to and authorized by CMS. These Medicare Advantage plans include, but are not limited to, dental, vision, hearing, premium reduction, and cost savings. Additionally, Agents will need to keep a record of any phone calls or online chats they have with clients that persuade them to continue paying into their current MA, Part D, or Cost plan.

The most recent changes to their definition of marketing focus on the definition's content element.

The definition's "content component" is "whenever any material or activity includes or addresses plan benefits, benefits structure, premiums, or cost sharing; measuring or ranking standards; or rewards and incentives."