Other Agency Guidance. It was a hot summer night when the Centers for Medicare & Medicaid Services (CMS) released the final version of the calendar year 2018 Medicare Marketing Guidelines (MMG), and a few hot summer days have passed while the industry digests the changes. Medicare-Medicaid Plan (MMP) Marketing Information & Resources Manatts Michael Kolber, a partner with our Manatt Health team, was quoted by Fierce Healthcare in an article about new medical marketing rules.. We plan to post a follow-up article shortly that breaks down the details and provide more insight, highlighting the most important changes. But, before you send anything, make sure you have the proper CMS-required Medicare disclaimers on the message. 4.3.1 MCO Notification of a Medicaid Other Event Form Instructions Maya Goldman. 6 Agent Marketing Guide/Medicare MARKETING TIP: OEP is a great time to shift to Age-In or other SEP activities . Marketing Medicare to Unsolicited Contacts. There are some changes to the guidelines from the 2019 season. Introduction 7 We think the new paragraph will help clarify the breadth of activities that are considered marketing activities, including activities for which the individual/entity expects indirect compensation. Below is a link to the 2019 Marketing guidelines for the 2020 season. For more information on what agents can and cannot do, review Medicare.govs Rules for Medicare health plans and the newly updated Medicare Communications & Marketing Guidelines. The Medicare Marketing Guidelines (MMG) implement the Centers for Medicare & Medicaid Services (CMS) marketing requirements and related provisions of the Medicare Advantage (MA, MA-PD) (also referred to as Plan), Medicare Prescription Drug Plan (PDP) (also referred to Medicare managed care marketing requirements are outlined in the Medicare Marketing Guidelines (MMG), 2. a sub-regulatory guidance document updated annually, which implements CMS marketing regulations for Medicare Advantage organizations, 3. including Dual Eligible Special Needs Plans (D-SNPs), 4. The Medicare Marketing Guidelines (MCMG) has seen some significant changes since its inception. Last updated: 6/16/2021 Based on current CMS regs and MCMG. Agents need to be aware of the differences between the two terms. The 2020 changes memo is to be used in conjunction with the 2019 Medicare Marketing and Communications Guidelines. The Medicare Communications and Marketing Guidelines (MCMG) interpret and provide guidance on the marketing and communication rules for Medicare Advantage (MA-only, MA- PD) plans (also referred to as plans), Medicare Prescription Drug plans (PDP) (also referred to Agent created communications to members do not need CMS approval. Furthermore, they mirror the rules of the Medicare Advantage and Medicare Prescription Drug Benefit. SPA and 1915 Waiver Processing. In CMS final Part C and D rule issued on January 19, 2021 (CMS4190F2, at 86 Fed Reg 5864), the agency codified many changes made in recent years to its marketing guidelines, including weakening the distinction between marketing and educational events. CMCS Medicaid and CHIP All State Calls. Medicare marketing guidelines for managed care. 5 The most recent memo from CMS is available below through the link. The publication reviewed the lack of ethics seen in the sales of profitable Medicare Advantage plans to seniors and how this issue prompted the Centers for Medicare & Medicaid Services to redefine marketing materials. Brokers may market both the current and upcoming plan years starting October 1. $211. 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). Consumers can easily access organizations NCQA statuses and other information on health care quality on NCQAs website at www.ncqa.org, or by calling NCQA Customer Support at (888) 275-7585. Medicaid enrollees must share lawsuit awards with states, Supreme Court rules. The Medicare Marketing Guidelines were formed to allow organizations to offer Medicare Advantage and Prescription Drug Plans. 422.2263 General marketing requirements. The Guidelines are for use by Medicare Advantage Plans (MAs), Medicare Advantage The Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that govern the selling and promotion of Medicare Advantage and Medicare Prescription Drug plans. 2 ). CMS.Gov. The Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that insurance companies selling plans must follow. To be eligible for Medicaid in FL, the essential requirements all Medicaid applicants must meet include: Applicants must be United States citizens. Its also a nice time to reach out to your clients to check in to confirm they know how to use their benefits as sometimes that can spark a request for permissible marketing information . Marketing services is a big part of every insurance company and agents job. With limited exceptions, the Rule requires an individuals written authorization before a use or disclosure of his or her protected health information can be made for marketing. These requirements also apply to Medicare- Medicaid Plans (MMPs), except as modified in state-specific marketing guidance for each states demonstration. Being a successful Medicare broker means being able to grow your business. SUBJECT: Chapter 3. Medicare Marketing Guidelines I. Medicare Marketing Guidelines (MMG) Section Change in this Guidance Document Section 10 Introduction Clarifies guidance on marketing start dates for CY 2015. This includes communication and marketing for sales and retention. Brokers Can Now Initiate Unsolicited Contact Through Email. CMS has renamed the guidelines the Medicare Communication and Marketing Guidelines (MCMG). We suggest using the Search tool in the left-hand navigation menu or CTRL + F to search for specific terms within the guidelines. The Medicare Marketing Guidelines (MCMG) has seen some significant changes since its inception. 4/23/2022. To govern the marketing and communications of Medicare Advantage, Part D prescription drug plans, and the 1876 Cost Plans, CMS establishes the Medicare Marketing Guidelines 5 and revises them annually. Consumers can easily access organizations NCQA statuses and other information on health care quality on NCQAs website at www.ncqa.org, or by calling NCQA Customer Support at (888) 275-7585. Provider Reverification Requirements to be Reinstated. The Centers for Medicare and Medicaid Services provide strict Medicare marketing guidelines for plan sponsors and providers. The Centers for Medicare & Medicaid Services released a memo outlining the changes to the Medicare Communications and Marketing Guidelines (MCMG) for the 2020 plan year. Unwinding and Returning to Regular Operations after COVID-19. 9. Compliance is an important aspect of offering Medicare plans. Communications Resources. Tools and Checklists for States. AEP is the busiest time of year for Medicare agents, so it is important to have a proper marketing plan in place. Making it more general than marketing, the new MCMG guidelines define communications as activities and use of materials to provide information to current and prospective enrollees. CMS will not review materials that fall into the communications category, but since marketing is now a subgroup of communications and more specific in nature, they Applicants must be residents of Florida. Definition of Medicare Marketing Materials . The disclaimers include: This information is not a complete description of benefits. With the end of the federal Public Health Emergency (PHE) expected in the Summer of 2022, NC Medicaid providers will begin receiving reverification notices. The HIPAA Privacy Rule gives individuals important controls over whether and how their protected health information is used and disclosed for marketing purposes. State Waiver and Amendment Approvals. The Medicare Marketing Guidelines (MMG) have seen some significant changes since 2019. CMS allows brokers to begin marketing for AEP on October 1. Verified employers. For example, you could hand out one of these items as a gift, as long as they are priced at $15 or less: A branded coffee mug. That included those to be used by agents or brokers. This chapter is currently located on the website at: https://www.cms.gov/Medicare/Health- Guidance for this document can be located at https://www.cms.gov/Medicare/Health-Plans/Managed Care 3.35 Uniform Critical Elements Requirements; Chapter 4: Marketing Policies and Procedures. We have provided an overview of the 2019 and 2020 changes below for agents review. No Fine Print, Please. Review your Medicare plan coverage options. Its a good idea to review your Medicare coverage every year to make sure the benefits of your Medicare plan remain aligned with your Make changes to your Medicare plan coverage during the right time of year. Find out what Medicare plan may fit your needs. We have tried to list the more common questions and aspects of the guidelines below. Marketing (as defined in 422.2260) must additionally meet the following requirements: One of the biggest changes in the new guidelines is how marketing materials are categorized. MMA - A New Market for Drug Management Drug management for private plans under Medicare regulators Pressure on price and performance Plan Sponsor premium competition Expanded out of pocket costs for beneficiaries Rebates and price transparency Cost effectiveness of drugs Pay for performance and risk sharing Informatics and monitoring We had a fantastic turnout for our webinar last week on the 2018 Medicare Marketing Guidelines ().Something Ill reiterate is that the MMG are for everyone. Part D Marketing Guidelines Published 53,000 words August 15, 2005 Address dos and donts for all potential marketers within the D arena. Reviewing and comparing the guidelines can be a time-consuming task. Formally known as the Medicare Marketing Guidelines (MMG), CMS regulations are now named the Medicare Communications and Marketing Guidelines (MCMG). CMS holds Plan Sponsors and Carriers responsible for anyone promoting their Medicare products . CMS holds the Plan Sponsor/ Carrier responsible for the actions of . There are three disclaimers to use when referencing benefits in marketing material, according to CMS (Medicare Marketing Guidelines, Appendix 2, No. ADDENDUM: Codifying Requirements for Medicare Communications and Marketing . SUMMARY OF CHANGES: CMS has revised the Medicare Marketing Manual to include clarifying existing language and incorporating recent policy issuances needed to CMS Medicare Communications and Marketing Guidelines (MCMG) DOs & DONTs Agent Summary . including the regulations at 42 C.F.R. or other qualified health care professional, per calendar month, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline Agents must. To date, CMS has not released an update or memo for 2021. Annual Enrollment Period for Medicare. Last updated: 6/16/2021 Based on current CMS regs and MCMG. The MMG, which governs Medicare Advantage Organizations (MAO) and Plan D sponsors, were also re-named to Medicare Communications and Marketing Guidelines (MCMG). To assist readers in finding elements that pertain to their type of organization, each section of these Guidelines is coded according to the below convention: 42 CFR Part 422, Subpart V Medicare Advantage Marketing Requirements 422.2260 Definitions concerning marketing materials. 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). CMS defines communications and marketing in the CMS Medicare Communications and Marketing Guidelines. This addition supports the direction received in the October 2021 HPMS memo on Third-Party Marketing.