Funder: Centers for Medicare & Medicaid Services

Author: Michelle Herman Soper, Center for Health Care Strategies, and Rivka Weiser, Mathematica Policy Research

July 2014 | Technical Assistance Brief


The Medicare and Medicaid programs have distinct requirements governing the way in which managed care plans communicate with and provide information to potential and current enrollees. Differences in marketing rules, materials, and practices reflect the programs’ different populations and benefits, as well as the fact that Medicare is administered at the federal level by the Centers for Medicare & Medicaid Services (CMS) while Medicaid programs are separately administered by each state.

This brief from the Integrated Care Resource Center (ICRC) provides an overview of Medicare and Medicaid managed care marketing requirements. It also highlights differences between marketing rules for these two programs and resulting challenges facing states that are developing integrated care programs for Medicare-Medicaid enrollees. Finally, the brief summarizes efforts to align managed care marketing rules and practices under Medicare and Medicaid, including new opportunities established by CMS through the Financial Alignment Initiative, innovative state approaches, and the Program of All-Inclusive Care for the Elderly (PACE).

This technical assistance brief is a product of the Integrated Care Resource Center made possible by the Centers for Medicare & Medicaid Services. The Integrated Care Resource Center is a national initiative to help states improve the quality and cost-effectiveness of care for Medicaid’s high-need, high-cost beneficiaries. The state technical assistance activities provided within the Integrated Care Resource Center are coordinated by Mathematica Policy Research and the Center for Health Care Strategies.