The Center for Medicare and Medicaid Services (CMS) is concerned with provider marketing activities for the following reasons:
Providers may not be fully aware of all AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid Plan) benefits and costs.
Providers may confuse the member if the provider is perceived as acting as an agent of the plan versus acting as the member's provider.
Providers may face conflicting incentives when acting as a plan sponsor representative.
To the extent that providers can assist a member in an objective assessment of his/her needs and potential options to meet those needs, they may do so. Providers may engage in discussions with a member should he/she seek advice.