In a May 10 letter to Medicare Advantage organizations and prescription drug plans, CMS said it will more closely scrutinize more Medicare Advantage marketing. The agency writes, starting on July 10, “Any material or activity that is distributed via any means (e.g., mailing, television, social media, etc.) that mentions any benefit will be considered marketing and must be submitted” to CMS for approval, according to the new memo.
Medicare Advantage Memo
In the memo CMS writes that it issued the document to “clarify the definition of marketing for Medicare Advantage-Prescription Drug Plans, stand-alone Prescription Drug Plans, 1876 Cost Plans, and Third-Party Marketing Organizations.” The agency defines marketing as “communication materials and activities which meet specific intent and content standards.” The intent of marketing is met when materials or activities are intended to draw a beneficiary’s attention to a plan or influence decision-making. The content of marketing is when material or activity includes plan benefits, structures, costs, rewards, and rankings.
CMS notes that to date the agency “has permitted the mentioning of widely available benefits (i.e. vision, dental, premium reduction, and hearing) in materials or activities without those materials or activities being considered marketing subject to the marketing regulations.” However, through reviews, CMS has found due to third-party marketing organizations, many beneficiaries inquire, and some enroll based on widely offered benefits advertised without information on the associated cost for enrollees. As a result, CMS is expanding its interpretation of the regulatory definition of marketing to include “content that mentions any type of benefit covered by the plan and is intended to draw a beneficiary’s attention to plan or plans, influence a beneficiary’s decision-making process when selecting a plan, or influence a beneficiary’s decision to stay enrolled in a plan”.
Therefore, beginning on July 10, any material or activity that is distributed and mentions a benefit will be considered marketing and must be submitted to the agency. CMS believes the new marketing safeguards “will help ensure that beneficiaries have accurate information when shopping for Medicare coverage and are protected from potentially misleading marketing activities.”