INSTRUCTIONS:
This form must be completed by all participating providers (also referred to as first-tier or downstream entities) existing and new, that will be displaying or providing marketing materials on behalf of the health plan.
Learn more about Provider Education Marketing in a Healthcare Setting.
Providers treating Medicare patients are required to follow a set of rules and standards established by the Centers for Medicare and Medicaid Services (CMS). These rules guide what you may and may not do in regard to discussing Medicare Advantage health plans with your patients.
CMS holds plan sponsors responsible for any comparative/descriptive material developed and distributed on their behalf by their contracting providers. Providers are not authorized to engage in any marketing activity on behalf of the plan without the express written consent of an authorized Health Plan representative, and then only in strict accordance with such consent.