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CMS Reinforces Ability to Go Digital

CMS Reinforces Ability To Go Digital

While the move has not gained great publicity since its announcement in the Medicare Communications and Marketing Guidelines (MCMG) on Jul. 20, 2018, at its Fall Conference earlier this month the Centers for Medicare and Medicaid Services (CMS) reiterated new guidance that allows plans to use digital means to fulfill most communications.

As we outlined in our recent blog post, there are huge long-term cost-savings, but at the same time cost, compliance, and HIPAA implications in the shorter term.

To refresh on the topic, the MCMG announcement outlined the following, with some clarifications below from the Fall Conference:

  • CMS is requiring that individuals opt into the digital provision of communications and that plans must have a mechanism for individuals to opt out and receive hard copies of materials on request. As CMS noted at the conference, email is no longer considered an unsolicited contact.
  • Two obvious means of providing communications digitally include secure email of the actual communication as well as member portal postings (with an email to the member notifying that the communication is on the portal that directs the member to the posting area).
  • CMS noted at the conference that text messages or other means of direct messaging are not allowed to fulfill communications.
  • CMS also noted that the email must provide an opt out function, and should contain language directing them on how to obtain a hard copy of the communication
  • The following information was also communicated:
    • Members should be able to call the plan and opt in to electronic communications.
    • If a member opts in to electronic fulfillment and then requests a hard copy, a member can be asked if this is a one-time request or are they opting out of digital permanently.
    • Delivery Date is defined as when an email is sent. CMS clarified it is not when the member opens the email.
    • A hard copy must be fulfilled on bounced emails.
    • If a plan encounters an invalid email, the delivery date is when the email was sent, not when the hard copy is sent/received.
    • If both email and hard copy are sent, the delivery date is the email sent date.

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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