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Does that CMS rule prohibiting MA seminar marketing apply to all MA plans or just PFFS?
Winter
Winter
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When CMS makes stupid decisions, it is for ALL plans.Does that CMS rule prohibiting MA seminar marketing apply to all MA plans or just PFFS?
Winter
When CMS makes stupid decisions, it is for ALL plans.
Rick
Does that CMS rule prohibiting MA seminar marketing apply to all MA plans or just PFFS?
Winter
Does that CMS rule prohibiting MA seminar marketing apply to all MA plans or just PFFS?
Winter
I'm in management in the MA industry, here's the scoop:
1. CMS regulations on MA plans cover PFFS, HMO and PPO across the board. At least right now.
2. New CMS regulations that take effect on October 1, 2008 stipulate that no meals are to be served at MA seminars. That rule is being interpreted generally that refreshments like water, juice, coffee and cookies are okay. At least right now. And that's not a problem, since we're all having to play by the same rules.
3. PFFS plans are on the way out, and will be gone by 2011, per Congress mandate. You'll see managed care plans (PPO and HMO) only after that, which is fine. Managed care plans are less costly to administer than PFFS, plus they're somewhat easier to explain and understand than PFFS.
As a result, the companies that are now just getting into the industry by offering PFFS plans are badly behind the curve. They'll have to be able to create strong networks between now and then, which won't be easy given the existence of the big boys, such as Kaiser, United and Humana.
One other - important - thing. CMS is not fooling around, and I don't blame them, given the amount of fraud and deceit aimed at seniors. If you're going to sell MA plans, get with a big carrier and follow the rules. No cold calling. No advertising without approval from the carrier. Nothing approaching high-pressure selling. Follow the rules, don't try to push the envelope.
A great industry, though. If you love working with seniors (and I do), there's no better place to be right now, in my humble opinion.
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