CMS Plans "Multi-faceted Surveillance Program" To Monitor Agent MA/PDP Activities As the Annual Enrollment Period (AEP) approaches and pre-selling commences, CMS has made us aware of its intentions to carefully monitor agent activity throughout the 2010 marketing season and beyond. CMS has indicated that it will institute a "multi-faceted surveillance program" to identify non-compliant marketing activities; as in previous years, this program will include "secret shopping" at scheduled marketing events and other presentations of our plans. According to CMS, its surveillance efforts will be focused on preventing, detecting and effectively responding to marketing abuses in order to ensure beneficiary protection and compliance. This includes working in close collaboration with State Departments of Insurance (DOIs) to monitor marketing activities in all 50 states. As part of these surveillance efforts, CMS will monitor Sales and Marketing events to ensure that the events are properly scheduled and, when necessary, cancelled, in compliance with CMS requirements. By extension, CMS will monitor these events to determine if they are being conducted in a timely and professional manner and to ensure that accurate information is being distributed. CMS will also evaluate whether or not agents are properly following regulations pertaining to nominal gifts, unsolicited contacts, prohibition of meals, and marketing at educational events. CMS will also monitor marketing events to determine if Medicare beneficiaries are being misled in any way. This would include the acceptance of unnecessary information, including signatures on an enrollment form that can be used to enroll individuals without their full consent. CMS has indicated that it will pay particular attention to vulnerable Medicare members, including those who are dual eligible and institutionalized, to help protect them from deceptive or high-pressure marketing tactics. If CMS suspects a violation, it will notify the Plans immediately. The Plan will contact the agent to obtain a statement. Agents who receive such notification are required to return a thorough response to the Plan within two business days, to allow the Plan to respond to CMS. Should you have any questions about CMS's 2010 surveillance initiatives, please contact the Career Sales Department at 800-275-6667 ext. 8819. | 
