Manages the alignment of MOAAs ( [M7XRM v:rY DXF4UbT+"J%p$ authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically ZbO KM~ Current guidance and model member materials issued by CMS through the Health Plan Management System (HPMS) appear below. What if a client would like to talk about additional or different products? Because these plansRead more, Free Medicare Lead Program (Turning 65/Med Supplement Leads) NOTE: We have updated our lead program. In addition, they can compare drug plans in a manner similar to the Medicare drug plan finder site. The Department may not cite, use, or rely on any guidance that is not posted Click Here, We do not offer every plan available in your area. https:// WebThe Medicare Advantage (MA) and Part D Marketing and Communications (MCMG) provides the marketing and communications requirements for Medicare Advantage (MA) plans, The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Agents are still not able to make unsolicited contact to prospects for MA, MAPD or PDP by phone or in person in common areas. website belongs to an official government organization in the United States. hbbd``b`>$ &$ .+ bX1 $"pH, $")s@Lz@`!3u>0 '` In other words, if you are talking Medicare with someone get a scope. Official websites use .govA ( The most recent memo from CMS is available below through the link. Federal government websites often end in .gov or .mil. Under the new CMS guidelines, agents selling Medicare Advantage plans can no longer use promotional materials that could mislead, confuse, or exaggerate the benefits of their plans. The .gov means its official. Toll Free Call Center: 1-877-696-6775. We can expect to see Christmas decorations just about everywhere. This chapter contains revisions in most of the sections within the manual chapter, however, there are some sections that have not been revised, but are included in this instruction as well. Toll Free Call Center: 1-877-696-6775. and which has been designated by CMS as meeting the requirements of an MA SNP as Share sensitive information only on official, secure websites. (SOA) The PTC is used to start contact with a prospect. ( The Guidelines are for use by Medicare Advantage Plans (MAs), Medicare Advantage Prescription Drug Plans (MA-PDs), Prescription Drug Plans (PDPs) and 1876 Cost Plans. Stay up to date with Medicare Marketing Guidelines by attending our Medicare Training Series live events! Model marketing materials include: the standardized Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) templates and instructions, ANOC/EOC Errata, and Provider Directory. ) Any information we provide is limited to those plans we do offer in your area. They are even needed if the meeting did not result in a sale. endstream endobj 560 0 obj <>>>/Lang( E N - U S)/MarkInfo<>/Metadata 52 0 R/Names 583 0 R/Outlines 643 0 R/OutputIntents 557 0 R/PageLayout/OneColumn/PageMode/UseOutlines/Pages 554 0 R/StructTreeRoot 81 0 R/Type/Catalog/ViewerPreferences<>>> endobj 561 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 43/Tabs/S/Type/Page>> endobj 562 0 obj <>stream lock The federal regulation at 42 CFR 438.104 defines marketing as any communication, from an [Medicaid managed care plan] to a Medicaid beneficiary who is not enrolled in that entity, that can reasonably be interpreted as intended to influence the beneficiary to Agent/Broker Training & Testing Guidelines are posted for Plans/Part D sponsors to use at a minimum, and is a high-level breakdown of the criteria for development of individual training and testing for agents/brokers. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare-Medicaid Plan (MMP) Marketing Information & Resources, List of Covered Drugs - English & Spanish, Provider and Pharmacy Directory - English & Spanish, Medicare-Medicaid Plan (MMP) Application & Annual Requirements, Medicare-Medicaid Plan (MMP) Reporting Requirements, Medicare-Medicaid Plan (MMP) Audit Programs, Medicare-Medicaid Plan (MMP) Encounter Data Reporting, Medicare-Medicaid Plan (MMP) Quality Withhold Methodology & Technical Notes, Medicare-Medicaid Plan (MMP) Chronic Care Improvement Programs & Quality Improvement Projects, CY 2023IllinoisMMP Model Materials Memo (PDF), CY 2023Illinois MMP Marketing Guidance (PDF), CY 2023 MassachusettsMMP Model Materials Memo (PDF), CY 2023Massachusetts MMP Marketing Guidance (PDF), CY 2023 Michigan MMP Model Materials Memo (PDF), CY 2023Michigan MMP Marketing Guidance (PDF), CY 2023Minnesota Plan Model Materials Memo (PDF), CY 2023Minnesota PlanMarketing Guidance (PDF), CY 2023 New York FIDA-IDD MMP Model Materials Memo (PDF), CY 2023New York FIDA-IDD MMP Marketing Guidance (PDF), CY 2023 Ohio MMP Model Materials Memo (PDF), CY 2023Ohio MMP Marketing Guidance (PDF), CY 2023 Rhode Island MMP Model Materials Memo (PDF), CY 2023Rhode Island MMP Marketing Guidance (PDF), CY 2023 South Carolina MMP Model Materials Memo (PDF), CY 2023South Carolina MMP Marketing Guidance (PDF), CY 2023 Texas MMP Model Materials Memo (PDF), CY 2023Texas MMP Marketing Guidance (PDF), Explanation of Benefits - Integrated & Drug-Only, Provider& Pharmacy Directory - English & Spanish, Annual Notice of Change - English & Spanish, Explanation of Benefits (EOB) - Drug Only & Integrated, Annual Notice of Change - English& Spanish, Explanation of Benefits (EOB) - Drug Only, Integrated Coverage Determination Notice (ICDN) Models, Provider & Pharmacy Directory - English & Spanish. On January 19, 2021, CMS issued a final rule entitled Medicare and Medicaid Programs; Contract Year 2022 Policy and Technical Changes to the Medicare View the Part C EOB materials in the Downloads section below. Starting January 1, 2023, Ambetter Value plan members can access providers in the below list for all medical needs. Sign up to get the latest information about your choice of CMS topics. Secure .gov websites use HTTPSA 422.2264: Beneficiary contact. Meetings and presentation fall under one of three categories. 559 0 obj <> endobj Sign up to get the latest information about your choice of CMS topics. <> website belongs to an official government organization in the United States. hbbd```b``"@$c*dHR0,f@0y,"IK 6w % $fk00120 FIGG 2 0 obj This means that all marketing materials must be clear, and accurate, and not promote any plans inappropriately. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare Communications and Marketing Guidelines 3-16-2022 (PDF), CY 2016 Medicare Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.28.13 (ZIP), CY2018MedicareMarketingGuidelines_Final072017 (PDF), CY2019 Medicare Communications and Marketing Guidelines_Updated 090518 (PDF), Medicare Marketing Guidelines 06.17.14 Updated with Issue Date (ZIP), Medicare Communications & Marketing Guidelines Update Memo - 8-6-19 (PDF), Medicare Advantage Marketing Regulations - 422 Subpart V, Medicare Part D Marketing Regulations - 423 Subpart V. means youve safely connected to the .gov website. ( An official website of the United States government It should focus more on promoting your services and general information about Medicare. or Cano Health Medical Centers Centrum Medical Center Fox Medical Center IMC Health Medical Centers MedFlorida Medical Center UniVida Medical Center Community Medical Group is currently the main provider for the Ambetter Value Network. sH2jy + a&@GJh& +%V,fpt!9'cfO+Ip|L2\1 H\n@yL. Most people who write articles haveRead more, Your email address will not be published. CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE. ) 200 Independence Avenue, S.W. The Centers for Medicare & Medicaid Services (CMS) received OMBs approval for the latest ANOC and EOC models through 12/31/21. You also must discuss the current star rating of plans and let the prospect know that it is out of 5 stars. This revision replaces Chapter 3, Medicare Marketing Guidelines for Medicare Advantage, Medicare Prescription Drug Plans, Prescription Drug Plans and 1876 Cost plans with a new revised Chapter 3. WebCMS COVID-19 Reporting Requirements for Nursing Homes June 2021 [PDF 300 KB] CMS Press Release: CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 [PDF 400 KB] CDC and CMS Issue Joint Reminder on NHSN Reporting You can decide how often to receive updates. Communication materials do not require CMS approval. Communication pieces are more general and provide non specific information. During a sales event: Sales events are an attempt to steer someone into a specific plan. %%EOF Sales events, on the other hand, are designed to steer, or attempt to steer potential enrollees towards a limited set of plans. As part of CMS implementation of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS has revised the Medicare Marketing Chapter to include the latest provisions in the current guidance. pgA +tKe.hT+mqOi^Ef(V: 09\O^]S`Uj0? %%EOF .gov All Rights Reserved. To sign up for updates or to access your subscriber preferences, please enter your contact information below. At that time, any new medical sales commissions due will be paid, starting from the first 2023 application. CMS also has rules for when you are allowed to market products and the way you can do it. 3 0 obj WebThe Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that insurance companies selling plans must follow. 582 0 obj <>/Filter/FlateDecode/ID[<5F2038F586BEA94FAD73980201E44AA1>]/Index[559 140]/Info 558 0 R/Length 121/Prev 362965/Root 560 0 R/Size 699/Type/XRef/W[1 3 1]>>stream PTC forms can now be used for more than one enrollment period. Medical commissions will be paid for up to four children on the plan. WebMedicare Marketing Guidelines . You can decide how often to receive updates. The Guidelines are for use by Medicare Advantage Plans (MAs), Medicare Advantage Prescription Drug Plans (MA-PDs), Prescription Drug Plans (PDPs) and 1876 Cost Plans. A Scope of Appointment form is used to document the types of plans you will be discussing with the client or prospect. PTC can be obtained through flyers, business reply cards, PTC forms online leads (Likes or shares on social media platforms are not valid) from vendors and other methods that prospects use to initiate contact. Even for events held by phone only. Guidance for this document can be located at https://www.cms.gov/Medicare/Health-Plans/Managed Care Marketing/Final Part C Marketing Guidelines. Medical Insurance Commissions Medical commissions apply to all metal levels and plans sold on or off Marketplace. means youve safely connected to the .gov website. WebEach year CMS and states participating in the Financial Alignment Initiative (FAI) jointly update state-specific marketing guidance and model member materials required for use by Please contact, on American Progressive Medicare Contracting. To date, CMS has not released an update or memo for 2021. Marketing Guidelines MCS Improving or Maintaining Mental Health MedPAC Medicare Payment Advisory contract year 2021 and 2022. An official website of the United States government If they would like to review non health related products such as life insurance, LTC, annuity, etc. Federal government websites often end in .gov or .mil. We have tried to list the more common questions and aspects of the guidelines below. Agents and brokers must record all calls (inbound and outbound calls) in their entirety, including calls to inform or educate clients about the event, as well as any post-event discussions. For Medicare Advantage Plans. There is no longer a rule that the SOA needs to be submitted 48 hours prior to the sales appointment. Director, Medicare Drug Benefit and C & D Data Group. But before creating any type of content, insurance agents must be able to identify the key traits that characterize their ideal audience. Ambetter Value plans are available in: Broward, Clay, Duval, Hillsborough, Lake, Miami-Dade, Orange, Osceola, Palm Beach, Pasco and Seminole counties. lock In addition, an email should not be intended to steer someone into a specific plan. 1 lock on the guidance repository, except to establish historical facts. If the materials are not generic in nature they will be considered marketing and require CMS review. The new marketing material module has enhanced functionality and will provide tools to Plans to facilitate tracking its marketing materials. WHY WORK WITH US? Medicare Marketing Guidelines For Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, Employer/Union-Sponsored Group Health Plans, Medicare-Medicaid Plans, and Section 1876 Cost Plans. Plans may now contact The agent will be the broker of record on any enrollment. Medicare Marketing Guidelines Marketing Models, Standard Documents, and Educational Material This section includes standardized outreach and educational material website belongs to an official government organization in the United States. endobj Agility Agents have learned from us that incorporating trending themes into their online content strategy plan will help them achieve their marketing goals. This FAQ walks through both permitted and Take a look for yourself below. ) The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Compliance is an important aspect of offering Medicare plans. How to become a Medicare agent If youre interested in how to, Online Enrollment- Enroll prospects online without the need for a face to face appointment. Cigna just announced their 2023 ACA commission schedule! Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. The key focus of being of patients over the CMS requirements on the healthcare industry. WebAll MA communication and marketing regulations and guidance issued by CMS, as well as other applicable laws, continue to apply to materials and activities of participating CMS requires all marketing websites to be submitted for review. A federal government website managed by the endstream endobj 160 0 obj <>>> endobj 161 0 obj <. HXUJjz9"UQM`v$,VT,]Xh"N`%J5.rEJj`= #Ba.2EJjUHql.D`.^b1:eV=}oK/{7*v>GcxlLtttoN|,ty0wt6M[d1a.HqE2_4Emc"dRx9xz0}/h@c/4d"OM x>4iKnfqp)utAzcl(sZvtx^ Issued by: Centers for Medicare & Medicaid Services (CMS). 698 0 obj <>stream General information is followed by state-specific information, which is alphabetized by state name. An official website of the United States government Sign up to get the latest information about your choice of CMS topics. 0 January 1 through March 31 is considered the OEP. Simply sign another scope documenting those products and continue the appointment. 189 0 obj <>/Filter/FlateDecode/ID[<731268243A464E09A5CB70A201055789>]/Index[159 61]/Info 158 0 R/Length 118/Prev 733811/Root 160 0 R/Size 220/Type/XRef/W[1 2 1]>>stream WebThe Centers for Medicare & Medicaid Services (CMS) reminds organizations of critical Medicare Part C and D readiness items prior to the 2020 Annual Election Period (AEP) and An official website of the United States government. 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). 'j0"0",NG)1p8i{^h38R ur@msO;F$A$gOyOOr[{YxqyIJ. Medicaid managed care plans contract with the state Medicaid agency. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Better to have one every time to be safe. Sign up to get the latest information about your choice of CMS topics. Provider Medicare Training & Marketing Guides | Health Net Skip to Main Content Healthnet.com uses cookies. CMS is finalizing a technical change to enable CMS to calculate the 2023 Part C Star Ratings for the three Healthcare Effectiveness Data and Information Set (HEDIS) measures collected through the Health Outcomes Survey: Monitoring Physical Activity; Reducing the Risk of Falling; and Bladder Control. You are able to start taking/submitting applications on October 15th. If you are showing plan specific details such as benefits or premiums you are engaging in a sales event. Medical Insurance Commissions Medical commissions apply to all metal 200 Independence Avenue, S.W. hb```a``Zk @16, TX3 document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); With licensed sales professionals in both the investment and insurance fields, the experienced and knowledgeable team at Crowe & Associates can tend to your various needs. Share sensitive information only on official, secure websites. OK Find a Provider t18:14Xw8zxs /0U4,P9L&009 =\.gi'Jo-=5I9)zwf?PGsr oom0\jd Z.F kD db3u2 They are educational events, sales events and individual appointments. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Marketing Models, Standard Documents, and Educational Material, Agent/Broker Dos and Don'ts - Translated (CY 2023) (ZIP), CY2023 Model Materials - Reissued 12-15-2022 (ZIP), CY2023_Part C_Translated_DSNP_Model_Materials_-_Chinese_and_Spanish (ZIP), Agent/Broker Dos and Don'ts - 9-2022 (PDF), CY_2023_Part C_Translated Model_Materials_Chinese (ZIP), CY_2023_Part C_Translated_Model_Materials_Spanish (ZIP), CY2023 Agent Broker Training Testing Guidelines - Updated 08-03-2022 (DOCX), Agent/Broker Dos & Don'ts - Translated (ZIP), Agent/Broker Dos & Don'ts - 9-2021_ (PDF), CY_2022_Part_C_Translated_Model_Materials_Spanish (ZIP), CY_2022_Part_C_Translated_Model_Materials_Chinese (ZIP), CY 2022 Agent-Broker Training and Testing Guidelines_revised 7-6-2021 (PDF), 2021_Part_C_Translated_Model_Materials_Spanish (ZIP), 2021_Part_C_Translated_Model_Materials_Chinese (ZIP), CY_2021_ MA_and_Section_1876_Cost_Plan_Provider_Directory_Model_7-08-2020 (PDF), 2021_Agent_Broker_Training_Guidelines_Revised (DOCX), 2020 Translated Part C Model Materials_Spanish 2 (ZIP), 2020 Translated Provider Directory Models (ZIP), 2020 Agent Broker Training Testing Guidelines (PDF), 2019 Model Materials Updated 12-13-18 (ZIP), 2019 Model Materials - Translations (ZIP), 2019 Translated Model Materials_Part C EOC_SPA (ZIP), 2019 Translated Model Materials EOC Chinese (ZIP), 2019 Agent Broker Training Guidelines_Revised 08.20.18 (PDF), 2018 Model Materials - Translations (ZIP), 2017 Model Materials - Translations (ZIP), 2015 Model Materials - Translations (ZIP).
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