June 9, 2021
Due to an increase in inquiries regarding referrals and referral bonuses and CMS’s updated direction advising “CMS no longer includes requirements about referral fees paid to non-agents/brokers in the Medicare Communications and Marketing Guidelines. However, any such fees would still be subject to general laws.”
Because of this, our stance is to advise that agents refrain from offering any incentives as an inducement for referrals to non-licensed individuals, providers, members, or consumers. If an agent wishes to provide an incentive, it is further advised that the agent contact the local Department of Insurance Offices per state to verify they are abiding by state-specific laws.
Payments for referrals. Payments may be made to individuals for the referral (including a recommendation, provision, or other means of referring beneficiaries) to an agent, broker or other entity for potential enrollment into a plan. The payment may not exceed $100 for a referral into an MA or MA-PD plan and $25 for a referral into a PDP plan.
• Leave business cards for distribution to friends and family
• Ask for and accept referrals (e.g. mailing addresses) from consumer/members
• Utilize conventional mail to send approved marketing information
• Send Thank You cards or notes in a compliant business relationship building activity
• Make unsolicited contact from referrals from current enrollees
• Offer incentives to non-licensed individuals as an inducement for a referral
• Make unsolicited phone calls
• Do not offer any item of value (e.g., gift card, flowers) either upfront to solicit, or afterward as a “thank you” in exchange for a referral from a provider, member, or consumer.
As always, we thank you for your support and cooperation. For questions or comments, please email us at Compliance@YourMedicare.com or you may call the toll-free number listed below.
FOR AGENT USE ONLY. NOT FOR USE WITH CONSUMERS.
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