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Have you seem this in the Bill that passed both the House and Senate by Veto proof margins.
Its not going to be pretty for a lot of agents, Thoughs?
SEC. 103. PROHIBITIONS AND LIMITATIONS ON CERTAIN SALES AND MARKETING ACTIVITIES UNDER MEDICARE ADVANTAGE PLANS AND PRESCRIPTION DRUG PLANS.
(bb) by striking ‘, and’ at the end and inserting a semicolon;
Its not going to be pretty for a lot of agents, Thoughs?
SEC. 103. PROHIBITIONS AND LIMITATIONS ON CERTAIN SALES AND MARKETING ACTIVITIES UNDER MEDICARE ADVANTAGE PLANS AND PRESCRIPTION DRUG PLANS.
- (a) Prohibitions-
- (1) MEDICARE ADVANTAGE PROGRAM-
- (A) IN GENERAL- Section 1851 of the Social Security Act (42 U.S.C. 1395w-21) is amended--
- (i) in subsection (h)(4)--
- (I) in subparagraph (A)--
- (i) in subsection (h)(4)--
- (A) IN GENERAL- Section 1851 of the Social Security Act (42 U.S.C. 1395w-21) is amended--
- (1) MEDICARE ADVANTAGE PROGRAM-
(bb) by striking ‘, and’ at the end and inserting a semicolon;
- (II) in subparagraph (B), by striking the period at the end and inserting a semicolon; and
(III) by adding at the end the following new subparagraph:
- (II) in subparagraph (B), by striking the period at the end and inserting a semicolon; and
‘(C) shall not permit a Medicare Advantage organization (or the agents, brokers, and other third parties representing such organization) to conduct the prohibited activities described in subsection (j)(1); and’; and- (ii) by adding at the end the following new subsection:
‘(j) Prohibited Activities Described and Limitations on the Conduct of Certain Other Activities-
- ‘(1) PROHIBITED ACTIVITIES DESCRIBED- The following prohibited activities are described in this paragraph:
- ‘(A) UNSOLICITED MEANS OF DIRECT CONTACT- Any unsolicited means of direct contact of prospective enrollees, including soliciting door-to-door or any outbound telemarketing without the prospective enrollee initiating contact.
- ‘(B) CROSS-SELLING- The sale of other non-health related products (such as annuities and life insurance) during any sales or marketing activity or presentation conducted with respect to a Medicare Advantage plan.‘(C) MEALS- The provision of meals of any sort, regardless of value, to prospective enrollees at promotional and sales activities.‘(D) SALES AND MARKETING IN HEALTH CARE SETTINGS AND AT EDUCATIONAL EVENTS- Sales and marketing activities for the enrollment of individuals in Medicare Advantage plans that are conducted--
- ‘(i) in health care settings in areas where health care is delivered to individuals (such as physician offices and pharmacies), except in the case where such activities are conducted in common areas in health care settings; and
- ‘(ii) at educational events.’.
(2) MEDICARE PRESCRIPTION DRUG PROGRAM- Section 1860D-4 of the Social Security Act (42 U.S.C. 1395w-104) is amended by adding at the end the following new subsection:
‘(l) Requirements With Respect to Sales and Marketing Activities- The following provisions shall apply to a PDP sponsor (and the agents, brokers, and other third parties representing such sponsor) in the same manner as such provisions apply to a Medicare Advantage organization (and the agents, brokers, and other third parties representing such organization):
- ‘(1) The prohibition under section 1851(h)(4)(C) on conducting activities described in section 1851(j)(1).’.
- (3) EFFECTIVE DATE- The amendments made by this subsection shall apply to plan years beginning on or after January 1, 2009.
- (1) MEDICARE ADVANTAGE PROGRAM- Section 1851 of the Social Security Act (42 U.S.C. 1395w-21), as amended by subsection (a)(1), is amended--
- (A) in subsection (h)(4), by adding at the end the following new subparagraph:‘(D) shall only permit a Medicare Advantage organization (and the agents, brokers, and other third parties representing such organization) to conduct the activities described in subsection (j)(2) in accordance with the limitations established under such subsection.’; and(B) in subsection (j), by adding at the end the following new paragraph:
‘(2) LIMITATIONS- The Secretary shall establish limitations with respect to at least the following:
- ‘(A) SCOPE OF MARKETING APPOINTMENTS- The scope of any appointment with respect to the marketing of a Medicare Advantage plan. Such limitation shall require advance agreement with a prospective enrollee on the scope of the marketing appointment and documentation of such agreement by the Medicare Advantage organization. In the case where the marketing appointment is in person, such documentation shall be in writing.
- ‘(B) CO-BRANDING- The use of the name or logo of a co-branded network provider on Medicare Advantage plan membership and marketing materials.‘(C) LIMITATION OF GIFTS TO NOMINAL DOLLAR VALUE- The offering of gifts and other promotional items other than those that are of nominal value (as determined by the Secretary) to prospective enrollees at promotional activities.‘(D) COMPENSATION- The use of compensation other than as provided under guidelines established by the Secretary. Such guidelines shall ensure that the use of compensation creates incentives for agents and brokers to enroll individuals in the Medicare Advantage plan that is intended to best meet their health care needs.‘(E) REQUIRED TRAINING, ANNUAL RETRAINING, AND TESTING OF AGENTS, BROKERS, AND OTHER THIRD PARTIES- The use by a Medicare Advantage organization of any individual as an agent, broker, or other third party representing the organization that has not completed an initial training and testing program and does not complete an annual retraining and testing program.’.
‘(2) The requirement under section 1851(h)(4)(D) to conduct activities described in section 1851(j)(2) in accordance with the limitations established under such subsection.’.(3) EFFECTIVE DATE- The amendments made by this subsection shall take effect on a date specified by the Secretary (but in no case later than November 15, 2008). - (A) in subsection (h)(4), by adding at the end the following new subparagraph:
- (1) MEDICARE ADVANTAGE PROGRAM- Section 1851(h) of the Social Security Act (42 U.S.C. 1395w-21(h)) is amended by adding at the end following new paragraph:‘(6) REQUIRED INCLUSION OF PLAN TYPE IN PLAN NAME- For plan years beginning on or after January 1, 2010, a Medicare Advantage organization must ensure that the name of each Medicare Advantage plan offered by the Medicare Advantage organization includes the plan type of the plan (using standard terminology developed by the Secretary).’.
