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CMS Memo: “Third Party Marketing” Creates a Ripple Effect Felt Far and Wide…Are We Having Fun Yet?

Anyone who has had the pleasure of navigating the Sales and Marketing Compliance realm this past year has experienced a brand-new challenge, which took the form of a smattering of uncoordinated and often ill-timed verbal and written guidance to sift through in order to answer the all-important question…”What is CMS’s intent?”

On October 8th, CMS released an HPMS memo titled Third Party Marketing,” providing much-needed guidance related to expectations around aspects of the new marketing material submission process which allows Third Party Organizations such as FMOs to submit materials directly to CMS, as well as expectations around sales oversight programs.

While much of the clarification within this memo should really be clear from previous guidance (e.g., don’t misrepresent yourself as a government agency), one key point was made within the guidance memo which was different than the way the vast majority of the industry had interpreted existing guidance.

CMS states within this guidance memo that “Advertisements intended to draw a beneficiary's attention to an MA plan or plans and include or address content regarding plan premiums, cost-sharing, or benefits information, including those not mentioning a specific plan by name (as well as instances where such advertisements are made on behalf of multiple MA organizations), are marketing as defined under 42 CFR§422.2260. Thus, these advertisements, as marketing materials, must be submitted to CMS prior to their use.”

Because the Annual Enrollment Period Marketing has already begun, this guidance will undoubtedly cause a significant operational headache to Third Party Marketing Organizations and MAOs alike.

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Third Party Marketing Memo 10-8-2021
Download PDF • 140KB

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