CMS Oversite of Agent Websites

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CMS recently posted this memo:


The Centers for Medicare & Medicaid Services (CMS) recently has been made aware of numerous 3rd party websites that market Medicare Advantage and Prescription Drug Plans in violation of CMS’ Medicare managed care regulations and Medicare Marketing Guidelines (MMG).

Third-party websites that market MA and Part D sponsors’ products are expected to meet applicable CMS marketing requirements. We have recently found numerous and troubling violations on 3rd party websites, such as:

• Inappropriate requests for health status information such as pre-existing conditions, weight, and whether the beneficiary smokes. See 42 C.F.R. §422.110(a), which prohibits discrimination on the basis of medical conditions or medical history. See also 42 C.F.R. §422.2268(c) and 423.2268(c), which prohibit discriminatory marketing practices.

• Misleading information, such as identifying a Medicare Supplement plan as a Medicare Advantage plan. See 42 C.F.R. §§422.2268(e) and 423.2268(e).

• Use of prohibited terminology, including unsubstantiated absolute superlatives. See section 40.4 of the MMG.

• Absence of required disclaimers. See section 50 of the MMG.

In accordance with 42 C.F.R. §§422.504(i) and 423.505(i), Plans/Part D Sponsors are responsible for ensuring that all materials, including websites created by subcontractors, are compliant with CMS requirements. Third-party websites that provide Plan/Part D Sponsor contracted agents with beneficiary leads are considered to be downstream entities of the Plan/Part D Sponsor. CMS expects Plans/Part D Sponsors to monitor 3rd party websites that
market on their behalf and to take appropriate and immediate action if the website is found to be non-compliant.

If a Plan/Part D Sponsor’s subcontractor, such as an agent/broker, is using a 3rd party website to market or obtain beneficiary information for the purposes of marketing and/or enrollment into a Medicare Advantage or Prescription Drug Plan, the Plan/Part D Sponsor will be held responsible
for the content of the website, as well as any agent/broker activity associated with the use of the inappropriate or misleading information, and will be subject to compliance actions.

Plans/Part D Sponsors are required to begin submitting all 3rd party websites that market their MA/Part D products into HPMS under Additional Websites beginning March 11, 2015. CMS requests that Plans/Part D Sponsors use the multi-plan submission process when possible.
 
•"Misleading information, such as identifying a Medicare Supplement plan as a Medicare Advantage plan."
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This is the part that I don't understand. I've heard of agents confusing these by giving the impression that a Medicare Advantage plan is a supplement, but not the other way around.
 
•"Misleading information, such as identifying a Medicare Supplement plan as a Medicare Advantage plan."
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This is the part that I don't understand. I've heard of agents confusing these by giving the impression that a Medicare Advantage plan is a supplement, but not the other way around.


You sometimes wonder if the folks at CMS really understand what they are doing.
 
You sometimes wonder if the folks at CMS really understand what they are doing.

They do not. They think agents are vermin because they represent the free market and that the government is the savior of the world. They are making it hard for the people in this market to have access to knowledgeable guidance. They are also losing some of the best talent who say it isn't worth it. For example who wouldn't want to have someone as knowledgeable as Somarco working in this market but he is not. The people who ultimately suffer at the hands of their stupidity is the consumer.
 
Gee Frank, thanks for the kind words.

As for the rest of your observations, I will put you down as undecided for now.
 
I have always believed CMS to exist because some bureaucrat had an imbecile as as child who couldn't qualify for anything else so they started a regulatory arm to give them a purpose.
 
CMS recently posted this memo:



Plans/Part D Sponsors are required to begin submitting all 3rd party websites that market their MA/Part D products into HPMS under Additional Websites beginning March 11, 2015. CMS requests that Plans/Part D Sponsors use the multi-plan submission process when possible.

Well crap, guess I picked the wrong week to starting building and ranking MAPD sites to sell leads. I knew I'd have to dig into the compliance stuff sooner than later but not this soon. Is anyone on here really proficient with this stuff? I'd love to pick your brain. Will supply some free leads for knowledge....
 
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