DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
Center for Medicare
7500 Security Boulevard
Baltimore, Maryland 21244-1850
MEDICARE DRUG & HEALTH PLAN CONTRACT ADMINISTRATION GROUP
DATE:
May 15, 2014
TO:
Medicare-Medicaid Plans
FROM:
Danielle R. Moon, J.D., M.P.A.
Director
SUBJECT:
New Marketing Codes for Medicare-Medicaid Plans (MMPs) in New York
CMS and New York have worked jointly on developing MMP-specific marketing codes for New
York Medicare-Medicaid Plans (MMPs). All the new codes are currently available in HPMS
(Monitoring / Marketing Review / Marketing Code Lookup) under category 16,000. MMPs
must use these codes to submit marketing materials and will not be able to use the existing
Medicare Advantage and Part D codes in the Marketing Module. Please note that the Marketing
Code Lookup functionality provides information about how each material code will be reviewed
(including file and use eligibility). MMPs in New York may not use MMP marketing codes
created for other states. Please note that the code descriptions for each code are appended with a
“(NY)” designation to ensure MMPs can distinguish between MMP codes for different states.
The chart below summarizes the current codes for New York MMPs; we will add new codes to
reflect new materials categories as needed.
Category 16,000 – New York Medicare-Medicaid Plans (MMPs)
New
Code
16700
16701
16702
16703
16704
16705
16706
16707
16708
16709
16710
Description
Summary of Benefits (NY)
MMP Welcome Letter for Passively Enrolled Individuals (NY)
Formulary (NY)
Provider/Pharmacy Directory (NY)
Other pre-enrollment documents (NY)
Errata Model - Annual Notice of Change (ANOC) / Evidence of Coverage (EOC)
(NY)
Combined Annual Notice of Change (ANOC) / Evidence of Coverage (EOC)/
Participant Handbook (NY)
Standalone Evidence of Coverage (EOC) / Participant Handbook (NY)
Standalone Annual Notice of Change (ANOC) (NY)
Explanation of Benefits (EOB) for non-Part D services (NY)
Member Identification Card (NY)
16711
16712
16713
16714
16715
16716
16717
16718
16719
16720
16721
16722
16723
16724
16725
16726
16727
16728
16729
16730
16731
16732
16733
16734
16735
16736
16737
16738
16739
16740
16741
16742
16743
16744
16745
16746
Non-Renewal Notice (NY)
Part D Offer Beneficiary Services (NY)
Part D Non-Coverage Notices (NY)
Part D Status Notices (NY)
Part D Rights Notices (NY)
Part D Notice of plan decisions (NY)
Part D Appeals and Grievance Forms/Letters (NY)
Part D Claims/Org. Determinations/Appeals/Grievances - CMS specified documents
(NY)
Integrated Denial Notice (NY)
Non-Part D Claims/Org Determinations/Appeals/Grievances - CMS specified
documents (NY)
General Advertising - Presales Material (NY)
Direct Mail Pieces (NY)
Newspaper (NY)
Radio (NY)
TV (NY)
Billboard/Banner (NY)
Internet Web Pages (NY)
Marketing Posters (NY)
Newsletters (NY)
Fliers (NY)
Envelopes (NY)
Physician Advertising Materials / Additional Promotions (NY)
Multi-Language Insert (NY)
Part D Explanation of Benefits (EOB) (NY)
Excluded Provider Model Letter (NY)
Prescription Transfer Letter (NY)
Utilization Management Notifications (NY)
Transition Notices (NY)
Formulary Change Notices (NY)
Formulary/Drug - CMS specified documents
Non-Renewal Script (NY)
Sales Presentations (NY)
Sales Scripts (NY)
Surveys/Assessments (NY)
Post Enrollment Member Outreach Scripts (NY)
Other Post-Enrollment Materials (NY)
Final Contract Year 2014 marketing policy guidance and some model materials for New York
MMPs were issued on May 2, 2014 and are posted at http://cms.gov/Medicare-MedicaidCoordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-CoordinationOffice/FinancialAlignmentInitiative/InformationandGuidanceforPlans.html. Additional model
materials will be issued via HPMS and posted to the same web page as they are finalized.
If you have any questions about the contents of this memorandum, please contact the MedicareMedicaid Coordination Office at [email protected].