Medicare managed care marketing guides issued

Medicare managed care marketing guidelines have been issued by the Department of Health and Human Services (HHS). HHS says the guidelines will help Medicare beneficiaries make informed choices about managed care plans. They 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 also will help expedite review of marketing materials by the Health Care Financing Administration (HCFA), according to HHS.

"Our beneficiaries need clear, understandable information as they decide whether to enroll in managed care, and, if they do, which plans meet their needs," says Donna E. Shalala, HHS secretary. "These guidelines will help make sure plans are providing consistent, accurate, and timely information so people can make informed choices in a fair marketplace. 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 than ever," says 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.