We aim to highlight the importance of due diligence in lead campaigns and to keep our customers and industry associates up-to-date with the compliance news reported for our industry. This article is reprinted here for our readers, courtesy of our partner organization, Professional Associations  for Customer Engagement (PACE).

BREAKING NEWS FROM: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS)

ACTION: Final rule.

SUMMARY: This final rule will revise regulations impacting marketing among other things for to programs Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes

EFFECTIVE DATE:  June 5, 2023.

CMS policy and technical changes to medicare programs pre-filed with the federal register

The final rule takes critical steps to protect people with Medicare from confusing and potentially misleading marketing while ensuring they have the accurate and necessary information to make coverage choices that best meet their needs.

The proliferation of certain television advertisements generically promoting enrollment in MA plans has been a specific topic of concern. To address these concerns, CMS is prohibiting ads that do not mention a specific plan name as well as ads that use words and imagery that may confuse beneficiaries or use language or Medicare logos in a way that is misleading, confusing, or misrepresents the plan.

In the rule, CMS also reinstates important protections that prevent predatory behavior and finalized changes that strengthen the role of plans in monitoring agent and broker activity. CMS is also finalizing requirements to further protect Medicare beneficiaries by ensuring they receive accurate information about Medicare coverage and are aware of how to access accurate information from other available sources.

CMS is finalizing 21 of the 22 provisions they proposed, with 17 of the 21 provisions being finalized as proposed.

The four provisions CMS is finalizing but modifying include:

1. Permitting agents to make Business Reply Cards available at educational events

2. Requiring an agent to tell prospective enrollees how many plans are available from the organization for whom the agent sells

3. Extending the length of time agents are able to re-contact beneficiaries to discuss plan options to twelve months

4. Allowing an agent to meet with a beneficiary without waiting the full 48-hour cooling off period when the timeframe runs up against the end of an election period, or a beneficiary faces transportation or access challenges, or the beneficiary voluntarily walks into an agent’s office.

CMS will continue to explore including the provision not finalized in this rule in possible future rule making.

Find out more with the pre-published download of the ruling: https://public-inspection.federalregister.gov/2023-07115.pdf

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