Medicare News
| For Immediate Release: | Contact: |
| Monday, September 08, 1997 | CMS Office of Public Affairs 202-690-6145 |
For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov. |
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MEDICARE MANAGED CARE MARKETING GUIDELINES RELEASED
The Department of Health and Human Services today is issuing marketing guidelines to help Medicare beneficiaries make informed choices about managed care plans.
The guidelines will inform health plans serving Medicare what is, and is not, allowed under Medicare managed care regulations on advertising, enrollment, and required notifications to Medicare beneficiaries. The guidelines will also help expedite review of marketing materials by the Health Care Financing Administration, which runs the Medicare program.
"Our beneficiaries need clear, understandable information as they decide whether to enroll in managed care and, if they do, which plans meet their needs. These guidelines will help make sure plans are providing consistent, accurate, and timely information so people can make informed choices in a fair marketplace," said HHS Secretary Donna E. Shalala. "And, they will help guard against potential marketing abuses by managed care plans as they compete for Medicare customers."
"With the rapid growth in the number and types of plans expected under the new Balanced Budget Act, clear marketing guidelines are more important now than ever," said HCFA Administrator Bruce C. Vladeck. "And it should be noted that these are guidelines and not regulations. That gives us more flexibility to make refinements as the managed care marketplace continues to evolve."
The guidelines clarify policies on advertising and promotions. For example, plans may give gifts to prospective plan members, but they are allowed only if they cost $10 or less each and are given out regardless of whether prospective members join the plan. Premiums for joining are not permitted.
The guidelines also include model letters, forms, benefit comparison charts and member contracts. They were developed in cooperation with the American Association of Health Plans, other health care industry representatives, and groups representing Medicare beneficiaries.
