decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Managed Care Model Compliance Plan / Compliance Tips and Tools / Marketing to Dual Eligibles - an Exception to the Rule
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Article Overview
This short compliance-focused article summarizes a CMS memorandum affecting Medicare+Choice marketing practices for dual eligible individuals. It is useful for managed care compliance staff, plan marketers, and coding/billing professionals who need to understand the general scope of Medicare and Medicaid-related marketing guidance, the approval process referenced by CMS, and the boundaries of permitted outreach discussed in the update.
Why This Topic Matters
Marketing rules for Medicare managed care plans can affect beneficiary access, plan communications, and compliance risk. This article helps readers identify when CMS carved out an exception related to dual eligibles and what oversight considerations were highlighted.
What You Will Learn
- The general CMS marketing context for Medicare+Choice plans
- How the article frames outreach to dual eligible beneficiaries
- The compliance review and Medicaid coordination points mentioned in the CMS memorandum
- The types of marketing practices CMS cautioned plans to avoid in this update
Who Should Read This
- Managed care compliance professionals
- Medicare plan administrators
- Health plan marketing staff
- Billing and coding professionals working with Medicare managed care content
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