Responding to concerns about marketing and sales of Medicare Advantage plans and Medicare Part D plans, the Centers for Medicare & Medicaid Services (CMS) has issued rules to prevent abuses and protect patients.

Generally, Medicare Advantage and Part D sponsors and their brokers or agents are prohibited from:

  • Using physicians or other provider groups to distribute printed information that compares the benefits of different plans (publicly available comparison information is permitted only if approved by Medicare);
  • Distributing and accepting enrollment forms in provider offices or at educational events;
  • Providing any gift with a value of more than $15 to prospective enrollees at sales events (cash, or items that can be readily converted to cash, and meals are prohibited regardless of value);
  • Marketing non-health care services and products, such as annuities, during Medicare Advantage and Part D sales, marketing activities or presentations;
  • Soliciting beneficiaries door to door, over the phone, or by other direct contact without the beneficiary first initiating the contact or giving permission for the contact;
  • Engaging in discriminatory activities (e.g., recruiting higher income beneficiaries without making comparable efforts to recruit lower income beneficiaries); and
  • Claiming that their plan is recommended by Medicare or that Medicare recommends that the beneficiary join their plan (they may explain that the organization is approved to participate in Medicare).

For more information or to report a problem, contact CMS at (800) 633-4227. You also may e-mail  Erin Gregorcyk  at TMA or call her at (800) 880-1300, ext. 1407, or (512) 370-1407; or contact the applicable Medicare Advantage or Part D sponsoring organization. 


Action , Oct. 2, 2009