Marketing and Communication. General Requirements In conducting any Marketing activities described herein, the Contractor shall: Ensure that all Marketing Materials clearly state that information regarding all MassHealth managed care enrollment options including, but not limited to, any Contracting MCOs, are available from the MassHealth Customer Service Center. The Contractor shall ensure that all written Marketing Materials prominently display the telephone number and hours of operation of the MassHealth Customer Service Center in the same font size as the same information for the Contractor’s customer service center, if any. EOHHS, in its sole discretion, may exempt, in writing, promotional materials or activities from this requirement upon written request by the Contractor; Submit all Marketing Materials to EOHHS for approval prior to distribution. The Contractor shall submit Marketing Materials to EOHHS for approval 60 days prior to distribution or as early as possible; Distribute and/or publish Marketing Materials in a non-targeted manner, as further specified by EOHHS, unless the Contractor submits a written request which is approved by EOHHS to implement a targeted Marketing campaign. A targeted Marketing campaign involves distributing and/or publishing materials (1) to a part of the Contractor’s service area as defined by EOHHS; or (2) where the campaign relates to a local event (such as a health fair) or to a single provider (such as a hospital or clinic), to a certain zip code or zip codes; and Provide EOHHS with a copy of all press releases pertaining to the Contractor’s MassHealth line of business for prior review and approval; Permissible Marketing Activities The Contractor may only engage in the following Marketing activities. A health fair or community activity, as further directed by EOHHS. The Contractor may conduct or participate in Marketing at health fairs and other community activities only if: Any Marketing Materials the Contractor distributes have been pre-approved by EOHHS; and Any free samples and gifts offered by the Contractor are only of a nominal value and are available to all attendees of the health fair or other community activity regardless of their intent to be attributed to the Contractor; The Contractor may participate in health benefit fairs sponsored by EOHHS, as further specified by EOHHS; The Contractor may market to Members in accordance with Section 2.6.A by distributing and/or publishing Marketing Materials in a non-targeted manner or implementing a targeted Marketing campaign that is pre-approved by EOHHS. The methods for distributing and/or publishing Marketing Materials may include: Posting written Marketing Materials that have been pre-approved by EOHHS at provider sites and other locations; and posting written promotional Marketing Materials at MCO-network provider and other sites as specified by EOHHS; Initiating mailing campaigns that have been pre-approved by EOHHS, where the Contractor distributes Marketing Materials by mail; and Television, radio, newspaper, website postings, and other audio or visual advertising. Prohibitions on Marketing and Enrollment Activities The Contractor shall not: Distribute any Marketing Material that has not been pre-approved by EOHHS; Distribute any Marketing Material that is inaccurate or false or that misleads, confuses, or defrauds the recipient of the Marketing Material, including but not limited to, any assertion or statement, whether written or oral, that: The recipient of the Marketing Material must enroll with the Contractor in order to obtain benefits or in order to not lose benefits; The Contractor is endorsed by CMS, the federal or state government or similar entity; Seek to influence a Member’s enrollment in conjunction with the sale or offering of any private or non-health insurance products (e.g., life insurance); Seek to influence a Member’s enrollment in conjunction with the sale or offering of cash, cash equivalents or in-kind gifts; Directly or indirectly, engage in door-to-door, telephonic, or any other Cold-call Marketing activities; Engage in any Marketing activities which could mislead, confuse or defraud Attributed Members, or misrepresent MassHealth, EOHHS, the Contractor, or CMS; Conduct any provider-site Marketing, except as approved by EOHHS; or Engage in Marketing activities which target Members on the basis of health status or future need for health care services, or which otherwise may discriminate against individuals eligible for health care services. Marketing Plan and Schedules The Contractor shall make available to EOHHS, upon request, for review and approval: A comprehensive Marketing plan including proposed Marketing approaches to groups and individuals; and Current schedules of all Marketing activities, including the methods, modes, and media through which Marketing Materials will be distributed. Annually, the Contractor shall present its Marketing plan in person to EOHHS for review and approval. Annually, the Contractor shall submit to EOHHS a written statement including an executive summary of its MassHealth Marketing plans and a statement that all of its Marketing plans and Marketing Materials are accurate and do not mislead, confuse, or defraud Members or the state.
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Sources: Contract
Marketing and Communication. A. General Requirements Requirements
1. In conducting any Marketing activities described herein, the Contractor shall: :
2. Ensure that all Marketing Materials clearly state that information regarding all MassHealth managed care enrollment options including, but not limited to, any Contracting MCOs, are available from the MassHealth Customer Service Center. The Contractor shall ensure that all written Marketing Materials prominently display the telephone number and hours of operation of the MassHealth Customer Service Center in the same font size as the same information for the Contractor’s customer service center, if any. EOHHS, in its sole discretion, may exempt, in writing, promotional materials or activities from this requirement upon written request by the Contractor; ;
3. Submit all Marketing Materials to EOHHS for approval prior to distribution. The Contractor shall submit Marketing Materials to EOHHS for approval 60 days prior to distribution or as early as possible; ;
4. Distribute and/or publish Marketing Materials in a non-targeted manner, as further specified by EOHHS, unless the Contractor submits a written request which is approved by EOHHS to implement a targeted Marketing campaign. A targeted Marketing campaign involves distributing and/or publishing materials (1) to a part of the Contractor’s service area as defined by EOHHS; or (2) where the campaign relates to a local event (such as a health fair) or to a single provider (such as a hospital or clinic), to a certain zip code or zip codes; and and
5. Provide EOHHS with a copy of all press releases pertaining to the Contractor’s MassHealth line of business for prior review and approval; ;
B. Permissible Marketing Activities The Contractor may only engage in the following Marketing activities.
1. A health fair or community activity, as further directed by EOHHS. The Contractor may conduct or participate in Marketing at health fairs and other community activities only if: :
a. Any Marketing Materials the Contractor distributes have been pre-approved by EOHHS; and and
b. Any free samples and gifts offered by the Contractor are only of a nominal value and are available to all attendees of the health fair or other community activity regardless of their intent to be attributed to the Contractor; ;
2. The Contractor may participate in health benefit fairs sponsored by EOHHS, as further specified by EOHHS; ;
3. The Contractor may market to Members in accordance with Section 2.6.A by distributing and/or publishing Marketing Materials in a non-targeted manner or implementing a targeted Marketing campaign that is pre-approved by EOHHS. The methods for distributing and/or publishing Marketing Materials may include: :
a. Posting written Marketing Materials that have been pre-approved by EOHHS at provider sites and other locations; and posting written promotional Marketing Materials at MCO-network provider and other sites as specified by EOHHS; ;
b. Initiating mailing campaigns that have been pre-approved by EOHHS, where the Contractor distributes Marketing Materials by mail; and and
c. Television, radio, newspaper, website postings, and other audio or visual advertising. .
C. Prohibitions on Marketing and Enrollment Activities The Contractor shall not: :
1. Distribute any Marketing Material that has not been pre-approved by EOHHS; ;
2. Distribute any Marketing Material that is inaccurate or false or that misleads, confuses, or defrauds the recipient of the Marketing Material, including but not limited to, any assertion or statement, whether written or oral, that: :
a. The recipient of the Marketing Material must enroll with the Contractor in order to obtain benefits or in order to not lose benefits; ;
b. The Contractor is endorsed by CMS, the federal or state government or similar entity; ;
c. Seek to influence a Member’s enrollment in conjunction with the sale or offering of any private or non-health insurance products (e.g., life insurance); ;
d. Seek to influence a Member’s enrollment in conjunction with the sale or offering of cash, cash equivalents or in-kind gifts; ;
e. Directly or indirectly, engage in door-to-door, telephonic, or any other Cold-call Marketing activities; ;
f. Engage in any Marketing activities which could mislead, confuse or defraud Attributed Members, or misrepresent MassHealth, EOHHS, the Contractor, or CMS; ;
g. Conduct any provider-site Marketing, except as approved by EOHHS; or or
h. Engage in Marketing activities which target Members on the basis of health status or future need for health care services, or which otherwise may discriminate against individuals eligible for health care services. Marketing Plan and Schedules The Contractor shall make available to EOHHS, upon request, for review and approval: A comprehensive Marketing plan including proposed Marketing approaches to groups and individuals; and Current schedules of all Marketing activities, including the methods, modes, and media through which Marketing Materials will be distributed. Annually, the Contractor shall present its Marketing plan in person to EOHHS for review and approval. Annually, the Contractor shall submit to EOHHS a written statement including an executive summary of its MassHealth Marketing plans and a statement that all of its Marketing plans and Marketing Materials are accurate and do not mislead, confuse, or defraud Members or the state.
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Sources: Contract for Mco Administered Accountable Care Organization