Medicare Marketing Modifications: The Old and the New

This February, Centers for Medicare and Medicaid Services (CMS) announced an update to the Medicare Communications and Marketing Guidelines (MCMG). The update represents a significant change to the MCMG and is effective for Contract Year (CY) 2022 for Medicare Advantage (MA) plans, section 1876 cost plans and Medicare Prescription Drug Plans (PDP).

What’s New in the MCMG?

CMS reorganized the MCMG to align with the regulatory requirements in 42 CFR Part 422 Subpart V and 42 CFR Part 423 Subpart V.

What is the Same in the MCMG?

Much of the same content is found in the revised MCMG, albeit in a different location. For example, the guidelines regarding “nominal gifts” that appeared in Section 40 in the previous version now appear under General Marketing Requirements.

The references to the Code of Federal Regulations are still listed for each of the sections. Also, most of the previous appendices are the same, except for the following:

Appendix Title
Previous Version
New Version
Pre-Enrollment Checklist
Appendix 3
Appendix 1
(as Standardized Pre-Enrollment Checklist)
External Links
Appendix 4
Appendix 5
Summary of Benefits Instructions
Appendix 5
Appendix 2
(as Model Summary of Benefits Instructions)
Employer/Union Group Health Plans
Appendix 6
Appendix 3
Use of Medicare Mark for Part D Sponsors
Appendix 7
Appendix 4

What is “Missing” from the MCMG?

The Call Center requirements and standards for hours of operation, average hold times and answer speed (formerly at MMG Section 80.1) no longer appear in the MCMG but remain codified at 42 CFR 422.111(h) and 42 CFR 423.128(d).[4]

“Disclaimers” as Appendix 2 has been removed and some of the disclaimers have been either removed or revised as follows:

Benefit Disclaimer
Availability of Non-English Translations
Plan Online Enrollment Center
Star Ratings
Revised with more information
Revised with more information
Special Supplemental Benefits for the Chronically Ill (SSBCI)
Provider Co-Branding Materials
Revised with more information
Materials Developed by a Third Party
Part D Sponsors with Limited Access to Preferred Cost Sharing Pharmacies
NCQA SNP Approval

Other Key Points:

Elixir has thoroughly reviewed the changes to the MCMG and is prepared to make any needed changes for any materials we produce for our Medicare clients.

[1] 42 CFR 422.2260; 42 CFR 423.2260

[2] Id.

[3] MCMG, Submission, Review, and Distribution of Materials, General requirements

[4] 86 FR 6005 (January 19, 2021).