New CMS Regs

midwestbroker

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CMS released the attached addendum to the Medicare Marketing Guidelines.

The part that raises concerns is this:

Section 70.6 Telephonic Contact
Section 70.6 of the MMG outlines permissible and prohibited telephonic activities of both agents/brokers and Plans/Part D Sponsors. We are clarifying that “plan business” means the member’s current plan. Agents may not contact members, via the telephone, to discuss other plan options. This is considered an unsolicited contact.

From what I understand this to read is agents cannot call non-clients who are in the same plan they are offering. In the original MMG it says agents can call clients as long as they are not baiting and switching topics.

Any other thoughts on this?
 

Attachments

  • mmg-corrected-8-14-14.pdf
    51.2 KB · Views: 24
I just heard that we can't talk about Value Added Benefits anymore. Except that the plan has VAB's listed in the SOB's. If they ask you about them then you can talk about them. Has anybody else heard this?

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From what I understand this to read is agents cannot call non-clients who are in the same plan they are offering.

If they are a "non-client" how do you know what plan they have?

Further if they have the same plan you are offering why would you want to call them anyway?

Forgive me if I'm missing something here.
 
All I could find is this;

Section 70.6 – Telephonic Contact
We clarify that FIDA Plans may not call current FIDA Plan Participants to promote other Medicare plan types. Information about other Medicare plan types can only be provided at the proactive request of a current FIDA Plan Participant. However, consistent with section 70.6 of the MMG, organizations that offer non-FIDA Plan and FIDA Plan products may call their current non-FIDA Plan Participants (for example, those in Medicaid managed long-term care products) to promote their FIDA Plan offerings. Callers with questions about other Medicare program options should be warm transferred to 1-800-Medicare or to the State Health Insurance Assistance Program (i.e., Health Insurance Information, Counseling, and Assistance, or HICAP) for information and assistance.

Wording is not 100% easy to read

But I think what its saying is you cant call current clients to switch plan unless they call you and request help

Maybe?

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And you know what I have not found where it may say it outside this 1

that in the summery it says
Clarifies that FIDA Plans may not call current FIDA Plan Participants to promote other Medicare plan

So does this only apply to Medicaid clients?

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I did not see your attachment

Now that I see it

I believe they are specifically talking about your current clients

that you cannot call them with the purpose of offering to change their plan if they do not ask for help
 
Pretty soon they are not going to let us call our existing policy holders at all. . . Can someone explain how this is all supposed to HELP clients? Other than to weed out the riff raff agents? I think most of us do things in the most ethical manner, in order to help our clients. Being regulated to death is not making me doing anything different than what I am already doing.
 
Pretty soon they are not going to let us call our existing policy holders at all. . . Can someone explain how this is all supposed to HELP clients? Other than to weed out the riff raff agents? I think most of us do things in the most ethical manner, in order to help our clients. Being regulated to death is not making me doing anything different than what I am already doing.

IDK

But If I understand it correctly(Not sure if I do)

It sounds like it restricts me from calling the client that had MA plan Go from $0 with $10 doc $20 spec $250 hosp
to $90 prem with $30 doc $50 spec $450 hosp

to let them know there are better options


That is where it stops me from doing what I would normally do anyway

I guess there is ways around it like asking them to call me when they get ANOC
and they will ask for help

But still
 
I'm sorry....what is FIDA?

So if a client has an hmo now and is unhappy.....don't bring up a ppo or med sup unless they request it? I guess they want to curtail plan switching during AEP and many agents call existing clients to gauge their satisfaction with current plan. We call it client retention....CMS thinks its farming.
 
I'm sorry....what is FIDA?

So if a client has an hmo now and is unhappy.....don't bring up a ppo or med sup unless they request it? I guess they want to curtail plan switching during AEP and many agents call existing clients to gauge their satisfaction with current plan. We call it client retention....CMS thinks its farming.

If I understand it correctly

If client calls you because they are unhappy then no problem

But you cant call them unsolicited with the purpose of offering different plan options

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Fully Integrated Duals Advantage (FIDA)
 
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