Medicare Communications & Marketing Guidelines (MCMG)—CMS Updates Warrant a Thorough Review

Last month, CMS published a new MCMG, and it looks quite different!

Not only is it much shorter, 51 pages compared to the previous 84 pages, it now has CFR references for all sections. Upon review, CMS has removed several details, seemingly anything without a CFR reference which accounts for the slimmed-down version, and it has added others.

This change supports CMS’s intention to move away from sub-regulatory guidance and direct plans to the CFR, and as such the MCMG has been structured to align with the regulatory requirements in 42 CFR Part 422 Subpart V and 42 CFR Part 423 Subpart V. Supporting this, CMS advises to use the MCMG in conjunction with the regulatory requirements to aid plans in understanding and complying with the regulations.

Let’s review a few of the changes:

• CMS added a detailed section to address the process of third-party entities submitting materials directly to CMS via HPMS. This is in addition to the Multi-Plan section. This addition supports the direction received in the October 2021 HPMS memo on Third-Party Marketing.
• CMS added an example of marketing with TV advertising, clearly addressing the effects and disruption of the industry from ads with celebrities like Joe Namath, also addressed earlier in the October memo.
• Many disclaimers and most definitions have been removed or incorporated into the main document, making it harder to locate them.

What plans should do now:

• The changes noted above warrant a thorough review of the MCMG. You can download the latest version here: https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/FinalPartCMarketingGuidelines
• Review related CFR references, as this is where the bulk of the guidance can be found, and train staff to do the same. Applicable CFR for Part C can be found here: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-V and for Part D here: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-V
• There are also several Links in Appendix 5 that are great references.
• Update Policies and Procedures and Job Aids to capture any changes and the current CFR references. On audit, CMS can ask for P & Ps, and they should be current for new regulations.

We expect to see similar changes to new releases of sub-regulatory guidance in the future.

We’re Here To Help—To find out how CODY^® can help your plan ensure audit readiness and maintain compliance, contact us today for a consultation.

About CODY: CODY^® works with over 70 government-funded, commercial, and ACA health plans across 50 states and Puerto Rico. We help align internal operations with CMS guidelines to improve regulatory compliance, maximize performance, and streamline member/provider communications across the enterprise. CodySoft^® and Membership Suite^™™, our proprietary suites of software, are designed specifically for health plans. www.codyconsulting.com