Who Approves Medicare Marketing Materials?

All marketing materials need to be filed and approved by CMS . Agent created communications to members do not need CMS approval.

What is CMS marketing rule?

Marketing Rules

CMS also regulates marketing and plan presentations , including when you’re allowed to market, and how you market. Agents must wait until October 1 to begin marketing next year’s plans to potential beneficiaries and cannot enroll members until October 15.

Who regulates all Medicare programs?

Department of Health and Human Services (HHS) The federal agency that oversees CMS, which administers programs for protecting the health of all Americans, including Medicare, the Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP).

What is 1 CMS marketing rule that impacts how Medicare insurance plans market to consumers?

Medicare has rules for how plans can contact you in different situations: By mail, radio, and print advertisements: Plans are allowed to market themselves by any of these means. ... Plans may only give them their contact information if they request it and if this is the case, the patient must be the one to call the plan.

What are CMS permission to call guidelines?

Specifically, the Medicare Permission to Contact (PTC) rule outlines when it is okay to contact a current or potential Medicare beneficiary, the specific products they are giving you permission to contact them for, how you can approach them, and when you can contact them.

What are the guidelines of marketing?

• Rule #1: Make Yourself Known. People are only going to do business with people they trust. ...
• Rule #2: Taking The Competition Seriously. ...
• Rule #3: Relate To Your Audience. ...
• Rule #4: Progress At The Speed Of The Audience. ...
• Rule #5: Making Your Customers Happy. ...
• Final Thoughts.

Is CMS a Medicare?

The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS).

What is the difference between the FDA and CMS?

Although FDA and CMS regulate different aspects of health care —FDA regulates the marketing and use of medical products, whereas CMS regulates reimbursement for healthcare products and services for two of the largest healthcare programs in the country (Medicare and Medicaid)—both agencies share a critical interest in ...

How Medicare is funded?

Medicare is funded through a mix of general revenue and the Medicare levy . The Medicare levy is currently set at 1.5% of taxable income with an additional surcharge of 1% for high-income earners without private health insurance cover. Medicare funds access to health care in two main ways.

What costs are not covered by Medicare?

Medicare does not cover private patient hospital costs, ambulance services , and other out of hospital services such as dental, physiotherapy, glasses and contact lenses, hearings aids. Many of these items can be covered on private health insurance.

When can you start marketing Medicare plans?

When Can I Start Marketing for the Annual Enrollment Period (AEP)? CMS allows brokers to begin marketing for AEP on October 1 . CMS rules (MCMG, Section 40) say that brokers can only market the plans they sell to beneficiaries who are eligible for valid enrollment (aka seniors enrolling during AEP).

How do I ensure Medicare compliance?

1. Develop standards of conduct. ...
2. Establish a method of oversight. ...
3. Conduct staff training. ...
4. Create lines of communication. ...
5. Perform auditing and monitoring functions. ...
6. Enforce standards and apply discipline. ...
7. Respond appropriately to detected offenses.

What are the three sources of revenue for Medicare Advantage plans?

Three sources of revenue for Advantage plans include general revenues, Medicare premiums, and payroll taxes . The government sets a pre-determined amount every year to private insurers for each Advantage member. These funds come from both the HI and the SMI trust funds.

What is permission to contact?

Permission to Contact (PTC) is permission given by the consumer to be called or otherwise contacted by a representative of UnitedHealthcare for the purpose of marketing a UnitedHealthcare Medicare Solutions product, including any Medicare Advantage (MA), Prescription Drug Plan (PDP), or Medicare supplement insurance ...

What is a Medicare statement of understanding?

By joining this Medicare health plan, you acknowledge that ‘Ohana will release your information to Medicare and other plans as is necessary for treatment, payment and health care operations. ... You understand that if you intentionally provide false information on this form, you will be disenrolled from the plan.

What events must be reported to UnitedHealthcare?

What type of events must an agent report to UnitedHealthcare? Only the marketing/sales events , both formal and informal. While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address.