MA marketing rules tighten thanks to reform law

by: Grant Huang Jun 7, 2010

Stock image from NIH photo gallery (public domain) Sellers of Medicare Advantage (MA) plans are now subject to tighter rules when it comes to marketing the insurance plans to seniors.

CMS released a transmittal updating a 200-page section of its Medicare Managed Care Manual that's effective June 4, to reflect provisions in the health reform law.

Here's a few highlights from Transmittal 93 on Medicare marketing guidelines, which was released June 4:

Promotional gifts, items or activities may not exceed $15 in cash value,
mailed advertisements for MA plans may no longer include enrollment forms,
MA plans may not selectively target Medicare beneficiaries from higher-income areas,
any promotional or marketing statements contained in hold messages -- when a beneficiary is placed on hold during a phone call to an MA plan -- must be first approved by CMS;
and in what may be the harshest blow, any advertising with endorsement of a plan by an individual MUST state whether that individual is being paid, and/or is an actor playing a fictitious plan member.

These rules come on top of stern measures CMS implemented in 2007 and 2008 that banned unsolicited telemarketing of MA plans and prohibited practices from letting MA marketers give presentations to patients.

When you factor in the pay cuts to MA plans that also came with health reform, this latest piece of rulemaking hits especially hard. MA plans are in for a powerful double-whammy; it's another reason to review our earlier guidance on what you can do to prepare for changes to your MA patients.

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