I got an Auto dialer call about Medicare

[patch36]

I didn't think any of these rules applied to Med Sups or the marketing of them? IF They do, where do they say so and why haven't any of us heard boo from the med sup companies, who are probably the driving force behind all of the rules and scrutiny to begin with...

 

[Dave020]

I didn't think any of these rules applied to Med Sups or the marketing of them? They do, and where do they say so an d why haven't any of us heard boo from the med sup companies, who are probably thre driving force behind all of the rules and scrutiny to begin with...

Lost me here. Are you saying that CMS marketing rules are being imposed on traditional supplements? I have not heard this at all. Can you provide source for this?
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I googled it and don't see anything saying CMS rules apply to anything except Part D and Part C. Also read the MIPAA guideline and there is no reference to any supplements, only parts c and d.
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Monday, September 15, 2008Contact:CMS Office of Public Affairs
202-690-6145

MEDICARE ISSUES NEW RULES TO ENFORCE MARKETING REQUIREMENTS DURING UPCOMING HEALTH AND DRUG PLAN ENROLLMENT PERIOD
​

The Centers for Medicare & Medicaid Services (CMS) today released final regulations that will protect Medicare beneficiaries from deceptive or high-pressure marketing tactics by private insurance companies and their agents during the upcoming 2009 Medicare Advantage and prescription drug open enrollment period. The regulations also include other non-marketing related Medicare Advantage and prescription drug plan (PDP) provisions.

The two regulations issued today include prohibitions on telemarketing and other unsolicited sales contacts. The new rules also prohibit financial incentives that could encourage agents and brokers to maximize commissions by inappropriately moving, or churning, beneficiaries from one plan to another each year. Plans must be in compliance with these provisions when they begin their marketing activities on October 1.

“The regulations give insurers bright-line guidance on what types of marketing activities are acceptable and what types are not acceptable,” said CMS Acting Administrator Kerry Weems. “Medicare beneficiaries can be assured that we will monitor marketing activities and move aggressively with enforcement measures or other actions if these rules are violated.”

Acting Administrator Weems emphasized CMS efforts that will build upon the success of past marketplace surveillance program activities to ensure that drug plans’ and health plans’ marketing practices reflect the new requirements. Surveillance will include:

• tripling the number of “secret shopper” activities in which a Medicare official poses as a prospective enrollee and monitors sales agents’ presentations for inaccurate information and prohibited sales tactics;
• reviewing plans’ local print and broadcast advertisements;
• reviewing recordings of enrollment calls to ensure compliance with the new regulations; and
• ensuring that health and drug plans detect, report, and respond to agent/broker marketing misrepresentation and other issues.

During last year’s open enrollment period, CMS’ marketplace surveillance activities included secret-shopping 300 sales and marketing events. As a result, three organizations were required to develop corrective action plans and one organization’s marketing activities were suspended. Other plans with lesser deficiencies received warning letters from CMS.

“The vast majority of beneficiaries are extremely pleased with their prescription drug and Medicare Advantage plans and have not encountered heavy-handed sales tactics,” said Weems. “CMS takes its enforcement role very seriously, however, and we will monitor activities throughout this year’s enrollment period to ensure that beneficiaries are protected from aggressive marketing behavior from agents and brokers.”

One regulation makes final several marketing revisions to the Medicare Advantage and Part D Prescription Drug Programs Proposed Rule that CMS issued on May 16. In July, Congress codified similar marketing restrictions in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The provisions prohibit:

• Providing meals to beneficiaries as part of marketing activities;
• Telemarketing, door-to-door solicitation, and other sales contacts made without a beneficiary’s express invitation;
• Cross-selling of non-health care related products during any sales, marketing, or presentation for an MA plan or PDP;
• Conducting sales presentations or distributing and accepting plan applications in provider offices or other places where health care is delivered; and
• Conducting sales activities, distributing, or collecting applications at education events.

In addition, the regulation requires that agents and brokers be state licensed and appointed in accordance with state laws. The marketing provisions must be in place when plans’ marketing activities begin October 1.

CMS also issued an interim final rule that would implement other provisions included in the new Medicare law. A key provision specifies restrictions on how agents and brokers are paid for signing up a beneficiary in a plan to eliminate incentives for agents or brokers to move beneficiaries from plan to plan, a practice known in the industry as churning. These guidelines, designed to protect beneficiaries from agents and brokers who may have been acting in their own financial interest rather than meeting the needs of the beneficiary, are based on existing industry standards for agent and broker compensation structure.

“This fall, Medicare beneficiaries will need to compare their current plan’s offerings for 2009 against those of other plans. As seniors compare the value and price of the plans offered, we want them to have complete confidence in the information insurers provide on benefits and costs of available plans,” said Weems. “These rules, in conjunction with other regulations CMS will issue before the annual enrollment period begins November 15, establish tighter performance standards and tougher penalties for non-compliance, ensuring a positive experience for beneficiaries as we move toward the start of annual enrollment.”

The final rule implementing MIPPA marketing requirements may be viewed at http://www.cms.hhs.gov/HealthPlansGenInfo/.

 

[GreenSky]

I'm nervous marketing for supplements. If the prospect tells me he has an MA plan, can I then turn the conversation around? Is that still a cold-call? What if he <shudder> asks about Part D at the same time?

Rick

 

[jdeasy]

I'm nervous marketing for supplements. If the prospect tells me he has an MA plan, can I then turn the conversation around? Is that still a cold-call? What if he <shudder> asks about Part D at the same time?

Rick

Here is what I got from UnitedHealthcare about that;

"Situation; A beneficiary calls the agent in response to advertising, word of mouth or other information:

Acceptable Actions:
-Needs assesment
-Present any product

Acceptable Outcomes
-Immedicate sale
-Schedule an in-home appointment{Requires scope of appointment documentation}
-Schedule attendance at a sales event
-Follow-up {send sales kit, schedule future activity or call}

Future permission to call
-For inbound calls, permission is automatically granted with no product restrictions as long as the inbound call is related to MA/PDP.
-Permission to call "duration" rules apply
-Caller may revoke permission to call"

 

[patch36]

Sorry Dave, I did not proofread. I left out the word 'If'.

Originally Posted by patch36
I didn't think any of these rules applied to Med Sups or the marketing of them? IF They do, where do they say so and why haven't any of us heard boo from the med sup companies, who are probably the driving force behind all of the rules and scrutiny to begin with...

I don't consider any of the new rules to do with Med Supps. If they do, please highlight the rule or reg.

 

[Frank Stastny]

Lost me here. Are you saying that CMS marketing rules are being imposed on traditional supplements?

NO!
Let's not get that ugly rumor started. I'm the one that brought it up in response to the call that was received saying "are you satisfied with your medicare plan".

I think Rick cleared that up in his post shown above.
It seems to me that every thing posted about Medicare is automatically assumed to be about PFFS plans or HMO's and PPO's. (Most posts even though they say MA they are really talking about PFFS)

The PFFS plans are what have caused all the BS that is going on now with CMS.

Besides, if CMS extends those same stupid-ass rules to Med Supps this is one agent who will constantly be in violation of that stream of crap.

And I am holding back!

 

[patch36]

I'm nervous marketing for supplements. If the prospect tells me he has an MA plan, can I then turn the conversation around? Is that still a cold-call? What if he <shudder> asks about Part D at the same time?

Rick

What is the worst possible outcome for you if you do sell someone a Med Sup that you may or may not have talked to about a MA, MAPD or PDP previously as long as you followed the 48 hour rule? I can't see any problem. The problem would be if you talked to someone about a Med Sup and then sold them a MA, MAPD or PDP at that appt.

What a freaking mess. But, I see no issue with selling a Med Sup under almost any situation, except during a scheduled MA, MAPD or PDP sales call. Then you would have to set another appt with the 48 hour rule.

If you drop the application on the floor during the presentation it is ok to use it as long as it wasn't on the floor over 5 seconds. The 5 second rule.

If you ride the client for 8 seconds you win, as long as the judges don't see you using your free hand.

 

[scottfree]

This is just one way someone or some company is trying to bend or get around the rules that CMS is trying to establish. There is always someone that is going to try and do this no matter what CMS does.

If it goes against the spirit of the law or rules then they will get fined.

Just my opinion.
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This is just one way someone or some company is trying to bend or get around the rules that CMS is trying to establish. There is always someone that is going to try and do this no matter what CMS does.

If it goes against the spirit of the law or rules then they will get fined.

Just my opinion.

Just want to add that if this call is about supplements when a senior calls back, then this should not be a problem. My thinking is that its not.

"are you satisfied with your Medicare plan" If this was for a supplement plan, wouldn't or shouldn't it say that in the message?

I hope they call floridabroker back so we can hear what they say.

 

[kdover]

Are we seriously saying that we can't even mention the word "Medicare" when talking about Med Supps?

 

[Frank Stastny]

If you drop the application on the floor during the presentation it is ok to use it as long as it wasn't on the floor over 5 seconds. The 5 second rule.

If you ride the client for 8 seconds you win, as long as the judges don't see you using your free hand.

The soccer moms have gotten the 5 second rule reduced to 3 seconds.

I have had appointments with prospects that I know I would have had to use two hands. Guess I will now have to start screening for that also in my initial call.

My guess is that there are going to be so many agents in violation in one way or another that to "arrest" all of them will not be practical. I predict that CMS will back off of a huge portion of what is currently their position.

What agents say on the board and the reality of what will be done starting November 15 may have no similarities at all.

PS I already have all my calls recorded for this year.

I have my staff in a recording studio as we speak doing hundreds of recordings that can have the date and name dubbed in as necessary. One guy is a master at sounding like hundreds of different people.