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How did the Medicare Improvement for Patients and Providers Act (MIPPA) of 2008 affect marketing for Medicare health and drug plans? []
With the passing of MIPPA in 2008, there were a few changes that Medicare health and drug plans must now follow when marketing to eligible beneficiaries. Most notably, as of Sept. 18, 2008, Medicare Advantage (MA) plans and Prescription Drug Plans (PDPs) are not allowed to engage in cold-calling and door-to-door solicitation without the potential enrollee initiating contact. One important exception is that agents who enrolled beneficiaries into MA or PDP plans may contact those enrollees without solicitation.

MIPPA also requires MA plans and PDPs to include the plan type in the plan’s name; however, this change is not effective until January 1, 2010. Plans are no longer allowed to display names or logos of co-branding network providers on plan members’ ID cards. Plans are not permitted to distribute or make available to beneficiaries at an educational event any materials that include plan-specific information or show bias to a plan, such as a plan enrollment form.

For a summary of these Marketing Guidelines refer to HAP’s chart, Medicare Drug Plans: Marketing Activities. For authority language, see CMS’s Marketing Guidelines for PDPs and Medicare Advantage Prescription Drug Plans (MA-PDs).

You also can read more detailed information on marketing by visiting the Marketing section of HAP’s Medicare Part D SHIP Resource Guide.

Are there specific requirements for information an agent must disclose to potential enrollees? []
No. However, HAP would like to hear from those of you who would like to partner with us to create a checklist of information the beneficiaries should ask agents before enrolling in a plan. Contact us to share your ideas!

In the meantime, we offer Alabama's Medicare Protection Toolkit as an example of a checklist for beneficiaries and agents. Thanks to the Alabama SHIP for offering this resource to assist other SHIPs.

To whom should beneficiaries report inappropriate marketing practices? []
If beneficiaries or SHIP counselors believe that a plan or provider is not following the marketing rules, they should immediately report such activities to their CMS Regional Office. A complete list of CMS Regional Office contact information is available on CMS’s website.

When counselors cannot resolve issues directly with plans, CMS encourages them to submit cases to the appropriate Regional Office for tracking and follow up through a central process. Counselors who help beneficiaries file grievances with their plans need to contact the plan or 1-800-MEDICARE to do so.

For more detailed information on marketing, visit the Marketing section of HAP’s Medicare Part D SHIP Resource Guide.

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Health Assistance Partnership
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