MA seminars or lack thereof

Aug 29, 2008

  1. Winter_123
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    Does that CMS rule prohibiting MA seminar marketing apply to all MA plans or just PFFS?

    Winter
     
  2. GreenSky
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    When CMS makes stupid decisions, it is for ALL plans.

    Rick
     
    GreenSky, Aug 29, 2008
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  3. Winter_123
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    That was my undersanding but I just spoke with an FMO that does just Humana plans and they insisted that it only applies to PFFS. Doesnt make sense to me but I dont really know so that is why I asked.

    Winter
     
  4. jdeasy
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    They haven't set the rule yet. But, when they do, it will be for all MA plans.
     
    jdeasy, Aug 29, 2008
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  5. allhealthandlife
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    don't know for sure about PFFS but i know that we have booked seminars for SecureHorizons PPO for November, The rub is that we can only offer a beverage and cookies and such at a nominal cost.

    To me this is a good thing because it will get rid of most of the free lunch for seniors groupies i had following me around last year.
     
  6. GreenSky
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    You are correct. You can have seminars but you can't serve food. What the definition of snacks is compared to food I just don't know.

    Rick
     
    GreenSky, Aug 29, 2008
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  7. Mac1958
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    I'm in management in the MA industry, here's the scoop:

    1. CMS regulations on MA plans cover PFFS, HMO and PPO across the board. At least right now.

    2. New CMS regulations that take effect on October 1, 2008 stipulate that no meals are to be served at MA seminars. That rule is being interpreted generally that refreshments like water, juice, coffee and cookies are okay. At least right now. And that's not a problem, since we're all having to play by the same rules.

    3. PFFS plans are on the way out, and will be gone by 2011, per Congress mandate. You'll see managed care plans (PPO and HMO) only after that, which is fine. Managed care plans are less costly to administer than PFFS, plus they're somewhat easier to explain and understand than PFFS.

    As a result, the companies that are now just getting into the industry by offering PFFS plans are badly behind the curve. They'll have to be able to create strong networks between now and then, which won't be easy given the existence of the big boys, such as Kaiser, United and Humana.

    One other - important - thing. CMS is not fooling around, and I don't blame them, given the amount of fraud and deceit aimed at seniors. If you're going to sell MA plans, get with a big carrier and follow the rules. No cold calling. No advertising without approval from the carrier. Nothing approaching high-pressure selling. Follow the rules, don't try to push the envelope.

    A great industry, though. If you love working with seniors (and I do), there's no better place to be right now, in my humble opinion.

    :)


    ...
     
    Last edited: Aug 30, 2008
    Mac1958, Aug 30, 2008
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  8. jdeasy
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    You may be in management, but, you are not giving the proper story here. You seem to be pushing for agents to get with a captive company.

    The CMS rules are not rules yet. They are guidelines at this point. They will most likely be rules that closely resemble the guidelines, but, many companies, obviously not your's, are feverishly negotiating with CMS over the implementation of many of the proposals and their effect on the industry and, more importantly, the seniors themselves.

    Nor has Congress mandated tha PFFS services be gone. That is just blatantly false. If your mangement is telling you that, it's time for new management. Now, the requirement for PFFS plans to have a network in counties where there are two or more companies will be the death knell of the PFFS. Unless, of course, there are changes made to the recomendations, which I fully expect to happen once the public gets an understanding of what's happened. A PFFS with a network is a PPO. Naturally in ruarl areas, there won't be a network and people will lose their PFFS in 3 years barring an intervention. That is not the same as a "Congress mandate".
     
    jdeasy, Aug 30, 2008
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  9. Mac1958
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    Well, I would point out where you are wrong as well, and you are, but I'm afraid I just don't care enough to do so.

    Additionally, I prefer to communicate with people who can be a bit more civil and mature in their responses.

    For the rest of you -- be careful, be sure to stay on top of the rules, don't break 'em, and you'll do great!

    ..
     
    Mac1958, Aug 30, 2008
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  10. Joe Moore
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    I have not seen it in print, however I have been told that even though meals cannot be served, and a "snack" can, the limit is still $15 that can be spent on an attendee.

    Must be expecting inflation to get real strong fast.

    Has anyone else heard anything on this? Or have I heard wrong?
     
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