Compliance Chronicles – Volume 3 – Special Edition 2023

CMS Updates Medicare Marketing Guidelines and Filing Requirements

On May 10, CMS updated their definition of what constitutes “marketing” to include content that mentions any type of benefit covered by Medicare Advantage plans and is intended to draw a beneficiary’s attention to a 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 (that is, retention-based marketing) and thus subject to review. As stated above, marketing requires both intent and content. Content that beneficiaries can receive benefits such as dental, vision, cost-savings, and/or hearing services is sufficient information about plan benefits, benefits structure, or cost-sharing to meet the content standard in the definition of marketing in §§ 422.2260 and 423.2260.

Beginning July 10, 2023, 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 for carrier review and approval and filing with CMS.

To avoid filing requirements, we recommend agents remove all references to benefits from materials and websites ahead of the July 10 deadline.

You can read the full CMS update here.

In addition, CMS has updated what is included in the scope of “television” materials to include online videos in addition to ads airing on TV. Effective immediately, all Television/Online Video media types that fall under the category of marketing must go through carrier review and approval, as well as a prospective 45-day CMS review. These changes became effective on 5/1/2023.