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It took a long time for CMS to come out with its proposed “catch-all” rules for Medicare Advantage (MA) and Part D plans, and because of the delay there’s very little time to incorporate them into this fall’s open-enrollment season. The regulations create significant new requirements that health plans need to prepare for quickly, especially in the sales commission arena.

The need for plan sponsors to have the same commission levels across all their MA products and the same levels across all their PDPs could result in significant changes in the way they do business. And this will have to be worked out quickly since 2009 marketing begins Oct. 1. Other tricky new rules you need to comply with include limits on the use of promotional items offered by plans to potential enrollees; bans on sales activities at such places as health information fairs, waiting rooms, pharmacy counters, long-term care facilities, and parking lots; a bar on offering meals and using all unsolicited forms of direct contact; and much more.

The consequences for violating the rules, which run 279 pages, are severe. CMS is proposing that it could levy a penalty of up to $25,000 for each enrollee affected, or likely to be affected, by any violation of its rules that adversely affects beneficiaries. That’s in addition to the impact of adverse publicity stemming from any charges brought by the feds.

Hear two top Medicare managed care and Part D experts from Gorman Health Group detail specific strategies you should implement promptly to ensure that your MA and Part D marketing is both effective and compliant under the new rules. Among the topics discussed are:

• What will plans need to do differently going into the 2009 benefit year marketing season? Are the handcuffs back on?
• How will the changes impact your timing for getting materials on the street?
• What are the operational challenges associated with the new regulations?
• What will be the impact of the commission changes mandated by CMS?
• What steps should plans take now to ensure compliance with the new marketing rules when they take effect?
• What marketing and sales pitfalls must plans avoid as they gear up for the rules?
• What should plans do to the maximize their Medicare marketing return on investment in the new environment?

Speakers

JEFF FOX is president of Gorman Health Group, LLC, the leading consulting firm specializing in Medicare managed care and Part D. Before joining GHG, he was vice president of government programs at Health Net of Arizona, overseeing all sales and marketing, enrollment, customer service, and appeals and grievances for the company’s Medicare products. While there, Mr. Fox’s responsibilities were also broadened to include oversight of all contracting and provider relations for all product lines.

MARY KAYE THIBERT is vice president of Gorman Health Group, LLC. An expert in managed care marketing, sales, and client services, Ms. Thibert’s achievements at GHG include development of marketing and sales plans, benefit designs and collateral  marketing materials. She also ensures that selling agents and plans are properly educated, trained, and compliant with Medicare’s marketing rules. Before joining GHG, Ms. Thibert established and implemented the overall brand strategy for a newly launched Medicare product, developed an in-house marketing design team, and implemented an automated sales lead generating system.
 
Moderator: Jim Gutman, vice president and executive editor at Atlantic Information Services, Inc.

Designed Especially For

• Health plan CEOs, CFOs, chief operating officers, compliance directors, product development and marketing executives, pharmacy directors, and government relations executives.

• Insurance brokers and agents.

• Pharmaceutical company executives and marketers.

• Executives of pharmacy benefit management companies.

• Attorneys and consultants.

Written Materials