Friday, August 31, 2012

CMS Announces New Marketing Regulations (Part 3)

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.

We've explained some of the motivation behind core rules in the CMS 2013 Marketing Regulations. This week, we'll take a look at some specific rules, and how they will impact your marketing materials in 2013.

First of all, CMS is requiring all plans to create a document called the Multi-Language Insert. This document must be included with the Summary of Benefits and the ANOC or EOC no later than September 30th, 2013. The Multi-Language Insert is a document that contains the following statement, printed in Spanish, Chinese, Tagalog, French, Vietnamese, German, Korean, Russian, Arabic, Italian, Portuguese, French Creole, Polish, Hindi, and Japanese.
“We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at [1-xxx-xxx-xxxx]. Someone who speaks [language] can help you. This is a free service.”
This statement cannot be modified, other than to include additional languages.

In addition to the Multi-Language Document, there are also materials that are required to be included with any electronic or printed enrollment form. These include
  • A Plan's CMS STAR Ratings Information
  • Summary of Benefits
New or renewing members at enrollment and thereafter must receive

  • Annual Notice of Change /Evidence of Coverage (ANOC/EOC) or EOC as applicable
  • Multi-Language Insert
  • Comprehensive formulary or abridged formulary (Part D sponsors only)
  • Pharmacy directory (For all plan sponsors offering a Part D benefit, this is required at time of enrollment)
  • Provider directory (For all plan types except PDPs, this is required at time of enrollment)
  • Membership Identification Card (required only at time of enrollment and as needed or required by plan sponsor post enrollment)
Too much to take in? Don't worry, we'll be wrapping up next week by revisiting some of the guideline rules that carried over from previous years.


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

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