As AEP approaches it’s important to remember CMS guidelines for marketing in a health care setting. These rules exist to protect Medicare beneficiaries from uninvited contact and high-pressure sales tactics.
Here are the key points to keep in mind:
Where to Meet
You can conduct sales or marketing activities in common areas, such as:
- Waiting rooms
- Lobbies
- Cafeterias
- Conference rooms
You cannot conduct any sales or marketing where patients receive care, such as:
- Exam rooms
- Dialysis centers
- Hospital rooms or private rooms in a nursing home or assisted care facility
- Pharmacy counters where patients consult with pharmacists
What Type of Event Are You Holding
CMS rules are different depending on the type of event you are holding.
Sales Events
The purpose of a sales event is to present specific Medicare plans and direct potential enrollees to particular plans or carriers.
- Informal sales event: You work at a booth, kiosk or table and offer plan information only upon request when approached by attendees.
- Formal sales event: You present plan-specific information to an invited audience.
You can:
- Use a sign-in sheet, as long as it makes clear that providing contact information is optional.
- Use only CMS and carrier-approved presentation materials.
- Name in advance all the products and plans you will be presenting.
- Hand out your business card and business reply cards (BRCs).
- Collect scope of appointment forms (SOAs) at least 48 hours before meeting with the individual.
- Collect an enrollment form only if the enrollee is eligible for a valid election period.
You cannot:
- Discuss any non-Medicare-related products at the event.
- Attempt to contact anyone who did not fill out an SOA or BRC.
Educational Events
The purpose of an educational event is to educate attendees on Medicare in general. You may not discuss specific plans, hand out materials with specific plan details, or attempt to steer attendees to any particular plan or carrier.
You can:
- Hand out generic CMS-approved educational materials.
- Hand out your business card and encourage attendees to contact you.
- Hand out business reply cards as long as they state that by filling out the card the individual is giving you permission to contact them.
You cannot:
- Display a sign-in sheet or ask for contact information.
- Discuss any non-Medicare-related products.
- Present plan specific information.
- Pass out of collect SOAs, applications or enrollment forms.
- Make any unsolicited contact. Attendance at an event is not considered permission to contact.
Rules for Gifts
CMS has set a single gift limit of $15 per item and cannot exceed a yearly limit of $75 per person. Gifts must be suitable for any client. They must be available to everyone in attendance and not be contingent upon enrolling in a plan. Food and refreshments are limited to light snacks and beverages.
Secret Shoppers
CMS and some carriers will send out secret shoppers to sales and marketing events posing as Medicare beneficiaries to ensure they are being held compliantly. Noncompliance can result in sanctions and even the loss of an agent’s license.
The Importance of Building Provider Partnerships
Establishing relationships with key partners in the provider community can build name recognition in your community and help you connect with potential clients looking for assistance with their Medicare coverage. Your provider partners can be assured that their patients are receiving advice from a trusted and knowledgeable source who is familiar with Medicare plans in their local area.
The team at PTT Financial is dedicated to your success. If you have questions, we are here to help. Contact us today.