Do's and Don'ts for Providers

Providers contracted with Plans (and their subcontractors) can:

• Provide the names of plans with which they contract and/or participate

• Provide information and assistance in applying for the limited income subsidy

• Provide objective information on specific Plan formularies, based on a particular patient's medications and health care needs

• Provide objective information regarding specific plans, such as covered benefits, cost sharing, and utilization management tools

• Distribute PDP marketing materials, including enrollment application forms

• Distribute MA and/or MA-PD marketing materials, excluding enrollment application forms

• Refer their patients to other sources of information, such as the State Health Insurance Assistance Programs, Plan marketing representatives, their State Medicaid Office, local Social Security Administration Office, CMS's Web site at http://www.medicare.gov/ , or calling 1-800-MEDICARE

• Print out and share information with patients from CMS's Web site

• Use comparative marketing materials comparing plan information created by a non-Benefit/service providing third-party (See section 10 under Marketing of Multiple Lines of Business, Non-Benefit/Service-Providing Third Party Marketing Materials)

Providers contracted with Plans (and their contractors) cannot:

• Direct, urge, or attempt to persuade, any prospective enrollee to enroll in a particular Plan or to insure with a particular company based on financial or any other interest of the provider (or subcontractor)

• Collect enrollment application

• Offer inducements to persuade beneficiaries to enroll in a particular plan or organization