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| Medicare Plan Marketing in the Regulatory Crosshairs: New Enforcement Initiatives |
Marketing of Medicare Advantage and Part D plans is in the crosshairs of federal regulators, and their trigger fingers seem to be getting more itchy with each passing month.
Medicare Plan Marketing in the Regulatory Crosshairs: New Enforcement Initiatives gives you the information you need to meet both current and future rules from CMS and the HHS Office of Inspector General. Among their areas of greatest emphasis:
- sales-agent misrepresentations and compensation,
- alleged improper outreach by plan sponsors,
- outbound enrollment verification calls, and
- the review period for marketing materials.
This report explains what actions have been taken against violators and why, and what proposed new rules are likely to mean for enforcement in the future. It includes details of new requirements, and lessons learned from regulatory actions already taken against marketing of specific plans — including big players like Humana and WellCare.
Gain insight on strategies plans are using to best deal with the complex task of marketing to the senior sector … while striving to achieve better adherence and consumer protections in the future. Order Medicare Plan Marketing in the Regulatory Crosshairs: New Enforcement Initiatives today!
Table
of Contents
Guidance and Guidelines for Medicare Advantage and Part D Marketing
- CMS’s Marketing Surveillance Could Lead to More Regulations
- CMS Issues Marketing Guidelines, Tightens Up Review Of Materials
- CMS Issues Its Final Guidance on 2010 MA/Part D Marketing
- Sponsors Must Pay Immediate Attention to New Marketing Rules or Face Stiff Penalties
- Plans Should Work on Scripts, Await Call Guidance, CMS Says
- New Rule Would Impose Burdens on Plans, but CMS Retreats on Downstream Entities
- CMS Erroneously Notifies 400,000 Seniors That MA Products Won’t Be Available Jan. 1, 2010
- Draft 2011 Marketing Rules Highlight New OEV Requirements
- OIG Report, Draft ’11 Marketing Guidelines Would Lead to More Regulation for MA Plans
CMS Enforcement of Marketing Regulations
- CMS Suspends Citrus Marketing, Enrollment
- WellCare’s Marketing Suspension Provides Compliance Lessons
- Kansas Blues Plan Using WellPoint to Administer PDP Is Sanctioned
- CMS Lifts WellPoint Suspension, Keeps Tabs on Plan’s Activities
- CMS Orders MA, Part D Plans to Stop Health Reform Mailings to Members
- CMS Warns Humana to Stop Mailings to MA Members on Potential Ill Effects of Reform
- CMS Slaps Humana on Wrist, Warns Plans of Improper Outreach
Agent/Broker Concerns
- New CMS Marketing Guidelines Could Signal Impending Change in Broker Pay
- CMS Sets Low-End FMV for Compensation, Moving Up ‘Low Outliers’ to Level the Field
- CMS Retrenches on Agent Compensation Guidance in Light of Widespread Confusion
- CMS Says It Will Train and Test Agents, Expects to Begin National Pilot
- CMS Issues Revised Guidance on 2009 Sales-Agent Compensation
- CMS Proposes MA Enrollment Assistance Demo, Seen as Step Toward Curbing Agents
- CMS Narrows Applicability of Outbound Verification Guidance
- Sponsors Should Monitor Agents’ Sales Events, Use Checklists
Written
By
This
book was written by the editorial staff of AIS.
Written
For
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Health plan business and financial managers (CEOs, CFOs, product and sales managers, government affairs managers)
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Executives of pharmaceutical manufacturers and PBMs
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Hospital and health system business and financial executives
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Consultants, actuaries, financial analysts and attorneys
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