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20-340 Align Your Marketing Materials with CMS Marketing Guidelines to Avoid Penalties

Date: 04/20/20

This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.

Updates to guidelines may affect materials you create for your Cal MediConnect patients

The Centers for Medicare & Medicaid Services (CMS) has renamed its Medicare Marketing Guidelines (MMG) to Medicare Communications and Marketing Guidelines (MCMG). Along with the title change, below are highlights of changes to the guidelines for 2019 and 2020.

Section	Description	Change
30.5	Use of TTY Numbers	Under Exceptions, added a third bullet: In television ads, the TTY number may be a different font size/style than other phone numbers to limit possible confusion.
30.6	Electronic Communication Policy	Added “Note: Text messaging and other forms of electronic direct messaging (such as social media platforms) would fall under unsolicited contact and is not permitted.”
30.9.1	Cobranding with Providers or Downstream Entities	Added to the sentence: Names and/or logos of cobranded providers on the plan’s enrollee identification (ID) card are prohibited, unless the provider names and/or logos are in the name of the plan name and/or are related to an enrollee’s selection of a specific provider/provider organization (such as physician, hospital or medical group).
60.1	Provider-Initiated Activities	Changed the sentence from “Permissible contracted provider-initiated activities include” to: CMS considers the following contracted provider-initiated activities to be outside the definition of marketing and, therefore, not subject to the regulation as marketing. Distributing unaltered, printed materials created by CMS, such as reports from Medicare Plan Finder, the “Medicare & You” handbook, or “Medicare Options Compare” (from www.medicare.gov) including in areas where care is delivered;

60.1

Provider-Initiated Activities

Providing the names of Plans/Part D sponsors with which they contract and/or participate;
Answering questions or discussing the merits of a plan or plans, including cost sharing and benefit information (these discussions may occur in areas where care is delivered);
Referring patients to other sources of information, such as State Health Insurance Assistance Program (SHIP) representatives, plan marketing representatives, State Medicaid Office, local Social Security Office, CMS’ website at www.medicare.gov, or 1-800-MEDICARE;
Referring patients to Plan marketing materials available in common areas; and
Providing information and assistance in applying for the low-income subsidy (LIS).

Cobranded materials must be approved

Health Net must approve any cobranded marketing materials distributed by providers to Medicare patients enrolled in a
Health Net Cal MediConnect Plan (Medicare-Medicaid Plan). This ensures all needed disclaimers and benefits are properly listed in the materials and approved by CMS.

Additional information

To review the complete calendar year (CY) MCMG, visit:

Relevant sections of Health Net’s provider operations manuals have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library, located on Health Net’s provider website at provider.healthnet.com.

Providers are encouraged to access Health Net’s provider portal online at provider.healthnet.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by county within 60 days at:

Line of Business	Telephone Number	Email Address
Cal MediConnect – Los Angeles County	1-855-464-3571	provider_services@healthnet.com
Cal MediConnect – San Diego County	1-855-464-3572	provider_services@healthnet.com

Last Updated: 04/20/2020