The Medicare Improvements for Patients and Providers Act (MIPPA)

[AJAX]

For those of you experienced agents in the Medicare Market. I'm sure you are familiar with The Medicare Improvements for Patients and Providers Act (MIPPA) and the marketing restrictions that were imposed on agents.

Have any of you encountered agents doing door-to-door marketing of Medicare Supplements and then moving into a Medicare Advantage presentation?

Technically Medicare Supplements are not regulated by MIPPA. And, these agents are obtaining a scope of appointment for the MA presentation. Does anyone have clarification as to whether or not this tactic is CMS compliant?

Please respond with facts and documents/proofs to back up your statements.

Please no smart responses.

 

[GreenSky]

Re: The Medicare Improvements for Patients and Providers Act (MIP

Tactics are likely not CMS compliant. If I cold call for a Med Supp and the person wants to volunteer that he has an MA plan and subsequently wants to meet, it's a gold.

You don't need a SOA form for Med Supps.

Rick

 

[AJAX]

Re: The Medicare Improvements for Patients and Providers Act (MIP

The door-to-door tactic is definitely shady. I think that is why CMS cut MA commissions in half. Some agents push their way in.

But, I definitely agree with you. If you have a CMS compliant conversation, and the Bene shows an interest in an MA it is Gold-They may save hundreds of dollars each month.

Do you know where I can locate MIPPA docs? It seems as if CMS hides their regulations on their web.

I wonder if they made any updates on this door-to-door solicitation Supp to MA move?

 

[GreenSky]

Re: The Medicare Improvements for Patients and Providers Act (MIP

Go to www.ritterim.com. He's got links to everything. May have to read the blog but it's well worth your time.

Rick

 

[Tampa Teddy]

Re: The Medicare Improvements for Patients and Providers Act (MIP

Heres a link to a pdf of all 280 pages.

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:h6331eh.txt.pdf

 

[dandan]

Re: The Medicare Improvements for Patients and Providers Act (MIP

Section A violation.

 

[Frank Stastny]

Re: The Medicare Improvements for Patients and Providers Act (MIP

Have any of you encountered agents doing door-to-door marketing of Medicare Supplements and then moving into a Medicare Advantage presentation?

With all of the "eyes" on us today it is very doubtful that an agent will admit to it here. Is it being done? You bet your life it is.

 

[Josh]

Re: The Medicare Improvements for Patients and Providers Act (MIP

For those of you experienced agents in the Medicare Market. I'm sure you are familiar with The Medicare Improvements for Patients and Providers Act (MIPPA) and the marketing restrictions that were imposed on agents.

Have any of you encountered agents doing door-to-door marketing of Medicare Supplements and then moving into a Medicare Advantage presentation?

Technically Medicare Supplements are not regulated by MIPPA. And, these agents are obtaining a scope of appointment for the MA presentation. Does anyone have clarification as to whether or not this tactic is CMS compliant?

Please respond with facts and documents/proofs to back up your statements.

Please no smart responses.

I've got an even better story for you than the door-to-door agents. A Medicare Advantage plan that *ONLY* sells Medicare Advantage is directly paying for telemarketed Medicare Supplement appointments. When the agents are running this appointments they collect a SOA form and write the app on the spot. According to this document I attached from UHC the agent has clean hands. How's that for a scandal?

 

[stormtracker]

Re: The Medicare Improvements for Patients and Providers Act (MIP

The carriers and government are in bed together over these ridiculious MA rules. There is no way this would fly if the carriers really didn't want it this way.

 

[AJAX]

Re: The Medicare Improvements for Patients and Providers Act (MIP

I've got an even better story for you than the door-to-door agents. A Medicare Advantage plan that *ONLY* sells Medicare Advantage is directly paying for telemarketed Medicare Supplement appointments. When the agents are running this appointments they collect a SOA form and write the app on the spot. According to this document I attached from UHC the agent has clean hands. How's that for a scandal?

I found this on the newly released MIPPA updates for 8/7/2009 effective immediately:

70.4 - Marketing through Unsolicited Contacts
(Rev. 91; Issued: 08-07-09; Effective/Implementation Date: 08-07-09)
42 CFR 422.2268(d), 423.2268(d)
As reflected in 42 CFR 422.2268(d) and 42 CFR 423.2268(d), "there is a general prohibition on marketing through unsolicited contacts. In general this prohibition includes the following and may extend to other instancesof unsolicited contact that may occur outside of advertised sales or educational events. Some examples include:
• Door to door solicitation; ................."







70.5.1 - Specific Guidance on Third-party Contact

(Rev. 91; Issued: 08-07-09; Effective/Implementation Date: 08-07-09)
42 CFR 422.2268(d), 423.2268(d)
[FONT=&quot]Sections 42 CFR 422.2268(d) and 42 CFR 423.2268(d) [/FONT].................................................
prohibit plan sponsors and their representatives from engaging in directunsolicited contact with potential enrollees, including outbound calls. This guidance applies to all downstream contractors, including third-party organizationsutilized to generate sales leads and/or appointments. As such, plan sponsors should keep in mind that CMS views the following activities as out of compliance:
[FONT=&quot]• Unsolicited MA plan or PDP marketing calls to beneficiaries (other than to current plan members if contracted by a plan, as previously described) to set up appointments with potential enrollees; [/FONT]




[FONT=&quot] ........... "[/FONT]Unsolicited calls to beneficiaries for non-MA and PDP products (for example, a “benefits compare” meeting) and providing those contacts to plans for ultimate use in an MA or PDP sales appointment; and
Sales of MA and PDP products are subject to our scope of appointment guidance, even if conducted during asales appointment for a Medigap policy. This includes the requirement for a beneficiary-completed agreement form prior to the appointment and a48-hour waiting period. Any plan sponsor or its representative that accepts an appointment to sell an MA or PDP product that resulted from an unsolicited contact with a beneficiary, regardless of who made the contact, will be in violation of the prohibition against unsolicited contacts."



In other words, both of these practices are a clear violation. In the case of an appointment for a Med Supp, and obtaining the SOA for an MA presentation, there is a 48 hour waiting period, because it was an unsolicited contact. Unsolicited is the key word.