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Communications and Marketing Changes from the Medicare Final Rule (CMS-4201-F)

The Contract Year 2024 Medicare Final Rule[1] (CMS-4201-F), published on April 12, 2023, provides a number of revisions to Medicare Advantage (MA) and Medicare Part D requirements. This article focuses on the updates within this Final Rule surrounding section I. MA and Part D Communications and Marketing (Subpart V of 42 CFR Parts 422 and 423). This section of the Final Rule speaks to the goal of protecting beneficiaries from marketing strategies that may be “misleading” or “confusing” when enrolling in MA and Part D plans.

Plans will need to update their documentation (e.g., policies and procedures, job aids) and processes to account for these changes and ensure that internal personnel and, if applicable, First Tier, Downstream or Related Entities (FDRs) (e.g., Third-Party Marketing Organizations (TPMOs)) comply with the revised requirements. 

Plans have a quick turnaround to implement these regulations as they are effective on June 5, 2023, and the communications and marketing provisions will apply to the 2024 contract year (enrollment efforts for the 2024 contract year begin September 30, 2023). As marketing materials need to be produced, reviewed (internally by the plan sponsor), and approved by the Centers for Medicare and Medicaid Services (CMS) before they are distributed to prospective enrollees, these deadlines are actually much sooner (summer 2023). 

Ankura has developed the following summary of the finalized proposals and suggestions for plans to consider when implementing these changes.

Ankura hopes that this summary has been helpful to you and your organization in preparing to implement these new requirements that were confirmed through the Final Rule. Ankura recommends that organizations review the documentation that has been published by the Department of Health and Human Services to understand the comments and responses to fully comprehend the intent and how these changes influence your communications and marketing efforts for the 2024 contract year.   

We are here to help.  Ankura has assisted many MA Organizations and Part D Sponsors with administering communications, marketing, and developing oversight and monitoring programs surrounding these provisions. We are prepared to assist your organization through the changes confirmed in the Final Rule and implement best practices. If you have questions about how Ankura can partner with your organization, please contact: Jeff Low, MHA, R.Ph and Richard Merino

[1] Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.

© Copyright 2023. The views expressed herein are those of the author(s) and not necessarily the views of Ankura Consulting Group, LLC., its management, its subsidiaries, its affiliates, or its other professionals. Ankura is not a law firm and cannot provide legal advice.


healthcare & life sciences, healthcare compliance, healthcare operations, article

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