CMS Announces New Marketing Regulations (Part 2)

CMS has approached the 2013 Marketing Regulations with a critical eye, and an editorial focus. In an effort to simplify and clarify the rules, CMS has removed around 70 pages from the document. Over the next few weeks, we’ll look at some of those changes, and explore what motivated CMS to make such drastic edits.

Last week, we introduced some of the basic concepts behind the latest version of CMS’ marketing regulations. Today, we’ll finish explaining the last two of three guiding principles that served as the basis for the document.

CMS clearly states plan sponsors are responsible for full disclosure when collecting and disseminating information to beneficiaries about plan benefits, policies, and procedures.

 This rule simply lays out transparency and responsibility for plan marketing and beneficiary information. For example, beneficiaries must be provided enough information to make an informed decision about health plans. In addition, plan sponsors must use sound judgment in all aspects regarding the beneficiaries and their delegated entities.

CMS states plan sponsors are responsible for documenting compliance with all applicable Medicare Marketing Guideline Requirements.

This rule ensures that plans:

•  Have systems and processes in place for all aspects of the marketing program,
• Provide oversight of those systems and processes, and
• That those processes are clearly defined and understandable.

As is always the case with these regulation documents, the focus of energy should be on providing the most transparent information possible for the beneficiaries and end users. Plan marketing needs to be developed in such a way as to provide the clearest possible idea for what a beneficiary is getting into.

Be sure to join us next week, as we delve deeper into the 2013 CMS Marketing Guidelines.

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Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.