Why are there Marketing Guidelines?
What marketing practices are and are not acceptable?
What are the penalties for not following the guidelines?

Why are there Marketing guidelines?
The Centers for Medicare and Medicaid Services (CMS) developed these guidelines to protect the interests of Medicare beneficiaries. These guidelines not only make it easier for CMS to monitor marketing practices and materials, they will also ensure consistency throughout the industry's marketing program. Most importantly, however, these guidelines assure that beneficiaries get the most accurate and consumer-friendly information and materials so that they can make informed health care decisions.

What are acceptable marketing practices?
The following are general guidelines:

• All activities and materials must fall within the CMS guidelines as well as federal and state laws.

• Marketing practices must give potential enrollees accurate information and cannot misguide them or misrepresent the benefits and services provided by the organizations that are marketing their products.

• Health plans should only promote products that pertain to health care and the services offered by the health care distributor.

• These plans should be promoted in such a way that the potential enrollee need not feel threatened in any way, discriminated against for any reason or obligated to purchase anything.

• Any materials, including web sites, distributed to members or potential enrollees require health plan approval, and in most cases, CMS approval.

• Materials that are required to be approved by CMS should be sent through the health plan for submission to CMS for approval.

More specific information can be found on the CMS Web site or by contacting your Marketing Consultant.

What are unacceptable marketing practices?

In addition to anything that doesn't comply with the information above or with the information provided in the CMS Medicare Part D Marketing guidelines, here is a list of unacceptable practices:

• Door-to-door sales;

• Charging a marketing or administrative fee for enrolling in Blue MedicareRx;

• Offering a retention or post-enrollment incentive;

• Use of non-CMS/Plan-approved materials;

• Marketing of non-health-related products with a PDP plan; and

• "Cherry picking," or pushing to enroll healthier beneficiaries in specific plans;

• Marketing outside the service area.

Again, this list is by no means exhaustive, and you should refer to the CMS Web site or contact your Marketing Consultant for more information.

Items offered to potential enrollees:

• must be of nominal value (worth a retail value of $15 or less);

• offered to all enrollees without discrimination;

• Cannot be in the form of cash or monetary rebates including gift cards and/or certificates.

Promotional activities such as raffles or door prizes at seminars, or other events, are acceptable as long as the prize is under $15 and promoted with the understanding that there is no obligation to enroll.

Note that marketing activities by contracted entities (i.e. Producers) are considered an extension of the health plan/PDP sponsor and therefore must follow CMS guidance.

If there are ever any questions pertaining to whether an activity or material is acceptable or not, please contact your Marketing Consultant.

What are the penalties for not following the guidelines?
There are serious repercussions for not following the CMS guidelines. If CMS receives complaints about potential violations, it will contact the agency that is the subject of the complaint and require that the problem be alleviated—which may result in termination for the individual violator. However, the agency itself may also face larger penalties, whether because of an individual employee action or a larger-scale violation. These penalties can range anywhere from civil monetary penalties to criminal charges to suspension of all marketing activities.