A Medicare Advantage marketing communications compliance program is the set of procedures a plan or agency uses to route each marketing and communications item through the right review, keep the required records and carry the required content, under 42 CFR Part 422 Subpart V. It is for plan compliance teams, and for the agencies that work with them, that have to show how materials are classified, reviewed and retained. Integral Healthcare Solutions (IHS) drafts the workflow, matrix, record procedures and training for your compliance leaders and counsel to approve.
Last updated: November 2026
What does 42 CFR Part 422 Subpart V require of Medicare Advantage marketing?
It requires an MA organization to send its marketing materials to CMS for review, and it limits what an MA organization can do while a review is open. Section 422.2261(a) says: "MA organizations must submit all marketing materials, all election forms, and certain designated communications materials for CMS review." Section 422.2262 adds that MA organizations "may not mislead, confuse, or provide materially inaccurate information to current or potential enrollees."
The governing text is 42 CFR Part 422 Subpart V, Medicare Advantage Communications and Marketing, eCFR built November 4, 2026, last amended October 8, 2026; page opened November 5, 2026. This page covers sections 422.2261, 422.2262, 422.2264, 422.2267 and 422.2274. Their latest amendments are at 91 FR 17582–17583, April 6, 2026. The final rule took effect June 1, 2026; its new marketing and communications policies apply to contract year 2027 marketing and communications beginning October 1, 2026 (page opened November 5, 2026).
| Section | What it asks, in IHS's words | What answers it |
|---|---|---|
| 422.2261(a)(1) | The Health Plan Management System (HPMS) Marketing Module is the primary system of record for collecting, reviewing and storing materials that must be submitted. | Submission log tied to HPMS records |
| 422.2261(b) | No marketing material or election form is distributed unless one of the listed conditions occurs. | Release gate in the review workflow |
| 422.2261(b)(2) | Deemed approval occurs if CMS has not rendered a disposition within 45 days of submission to CMS, or 10 days for CMS model or standardized marketing materials under section 422.2267(e). | Review clock on the submission log |
| 422.2261(b)(3) | File and Use permits distribution of CMS-designated material types 5 days after submission, with certification of compliance with sections 422.2260 through 422.2267. | Certification sign-off step |
| 422.2262 | Do not mislead, confuse or give materially inaccurate information. The section lists terms to avoid, including use of the word "free" for a zero premium. | Content check against the section |
| 422.2264 | Before a personal marketing appointment, the plan (or the agent or broker) agrees on and records the Scope of Appointment with the beneficiary, in writing for in-person appointments. | Scope of Appointment record |
| 422.2267(a)(1) | Required materials use a 12 point font, Times New Roman or equivalent. | Format check for required materials |
| 422.2267(a)(2) | Required materials are translated into any non-English language that is the primary language of at least 5 percent of the individuals in a plan benefit package service area. | Language analysis by plan benefit package |
| 422.2274(b)(2) | Among the agent and broker requirements is being trained and tested annually, with a score of 85 percent or higher on all forms of testing. | Annual training and test records |
| 422.2274(g)(2)(ii) | TPMO agreements with an MA plan or its first tier, downstream or related entity (FDR) must ensure all marketing and sales calls, including web-based audio, are recorded and retained in full for at least 6 years; the first 3 years require audio. | Call recording retention procedure |
The takeaway: each item produces a record, such as a log entry, a sign-off, a recording or a training result. The subpart separates marketing materials, communications materials and required materials. In IHS's reading the review path depends on which kind an item is (CMS review, deemed approval or File and Use), so a program starts by classifying every item. The six-year minimum here concerns TPMO marketing and sales call recordings; counsel reviews other retention obligations.
Who needs it and what triggers it?
Any MA organization needs a way to classify, review and keep records of its materials, and so does an agency that works for one. These triggers are IHS's reading, not a list from CMS.
- A plan or agency must route materials through review and keep required disclaimers, and has no written workflow.
- A plan uses third-party marketing organizations, agents or brokers, which brings in the agent and broker requirements of section 422.2274.
- A non-English language is the primary language of at least 5 percent of individuals in a plan benefit package service area, triggering required-material translation.
- Personal marketing appointments need a recorded Scope of Appointment before they take place.
How IHS helps
IHS assesses gaps, maps evidence and drafts the classification workflow, required-content matrix, recordkeeping and oversight procedures, training plan and monitoring calendar. We conduct a mock review and support readiness; your compliance leaders and counsel approve the drafts. Integral Healthcare Solutions (IHS) was founded in 2002 by Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC, and works across three practice lines: accreditation consulting, compliance services and program development. This build sits in our Compliance Services practice line.
Your plan or agency supplies the inventory of materials, channels, vendors, agents and brokers, your HPMS submission records and CMS dispositions, your call recordings and Scope of Appointment records, and counsel's review of compliance determinations.
The limit: IHS does not submit materials to HPMS or communicate with CMS, because the plan does. IHS does not give legal opinions on whether a given communication complies, and it does not sell or market plans.
What to have ready
Checklist sources: 42 CFR Part 422 Subpart V, eCFR built November 4, 2026; each linked section was opened November 5, 2026.
- Material inventory by channel (section 422.2261(a)).
- HPMS submission records and CMS dispositions (section 422.2261(a)(1)).
- File and Use eligibility, submission dates and certifications (section 422.2261(b)(3)).
- Vendor, TPMO, agent and broker inventory (section 422.2274).
- Annual training and test records (section 422.2274(b)(2)).
- Personal marketing appointment Scope of Appointment records (section 422.2264(c)(3)(i)).
- Marketing and sales call recordings, retention procedure and TPMO contract terms (section 422.2274(g)(2)(ii)).
- Translation analysis by plan benefit package (section 422.2267(a)(2)).
If these are scattered across departments, book the free introductory call and bring what you have.
How does outside drafting support compare with other routes?
A plan can review materials with its own compliance and marketing staff, buy workflow software, use counsel for legal determinations or add outside drafting support. Workflow software handles routing and storage, and the classification rules and procedures still have to be written, which is IHS's inference. Counsel answers legal questions, which IHS does not. IHS drafts the procedures and records for your team to adopt. IHS does not tell you which to use. For accreditation of a Medicare Advantage organization, see our page on URAC Medicare Advantage accreditation, which is a different service.
What does it cost?
The reviewed CMS sections do not publish a fee schedule for developing this program. IHS scopes each engagement after a free introductory call. Scope depends on plans and contracts, material volume, channels, vendors, agents and brokers. Include your compliance and marketing staff time in the budget.
What this is not
This is not legal advice. IHS is a consulting firm, not a law firm, and your counsel decides whether a communication complies. It is not a guarantee that CMS accepts any material. IHS does not submit anything to CMS or HPMS; the plan does.
Frequently asked questions
What does 42 CFR Part 422 Subpart V require of MA marketing and communications?
MA organizations must submit all marketing materials, all election forms and certain designated communications materials for CMS review. They may not mislead, confuse or give materially inaccurate information to current or potential enrollees. The subpart also sets format, translation, agent and broker, and call recording rules. IHS drafts the procedures that carry these into daily work.
Which materials must be submitted to CMS, and what is the HPMS Marketing Module?
Section 422.2261(a) says MA organizations must submit all marketing materials, all election forms and certain designated communications materials for CMS review. The Health Plan Management System (HPMS) Marketing Module is the primary system of record for collecting, reviewing and storing the materials that must be submitted. Section 422.2261(b) then lists the conditions under which material may be distributed, so a written workflow has to track which one applies.
Which terms can an MA organization not use?
Section 422.2262 lists terms and practices an MA organization may not use, and one of them is the word "free" to describe a zero premium. IHS drafts a content check that carries the whole list for your compliance team and counsel.
What do required MA materials have to look like?
Section 422.2267(a)(1) calls for a 12 point font, Times New Roman or equivalent. Section 422.2267(a)(2) calls for translation into any non-English language that is the primary language of at least 5 percent of the individuals in a plan benefit package service area. IHS drafts a format and language check by plan benefit package.
How long must marketing and sales calls be recorded and kept?
Section 422.2274(g)(2) covers TPMO contracts, written arrangements and agreements with an MA plan or its first tier, downstream or related entity (FDR). They must ensure all marketing and sales calls, including web-based audio, are recorded and retained in their entirety for at least 6 years. The first 3 years require audio; years 4 through 6 permit audio or complete and accurate transcript recordings. IHS drafts the retention procedure; counsel reviews other retention obligations.
What must agents and brokers have to represent an MA organization?
Section 422.2274(b)(2) requires annual training and testing under (c)(4), with a score of at least 85 percent on every form of testing. Training covers Medicare rules, products the agents and brokers will sell, plan-specific details, and relevant State and Federal requirements; IHS drafts the training plan for client review.
What is a Scope of Appointment, and when must it be recorded?
The Scope of Appointment records the marketing topics agreed with the beneficiary before a personal marketing appointment. Under section 422.2264(c)(3)(i), the plan, agent or broker, as applicable, must agree upon and record it before the appointment; in-person appointments require it in writing. IHS drafts the form and retention procedure.
Should a plan build a materials review workflow in-house, with software or with outside drafting support?
The choices can be combined. Software handles routing and storage, but classification rules, release gates and records still have to be written. An in-house build uses compliance and marketing staff time. Outside drafting support adds a writer and a gap assessment. IHS does not recommend one over the others.
What does an MA marketing compliance program cost to build?
The reviewed CMS sections do not publish a fee schedule for developing this program. IHS scopes each engagement after a free introductory call. Scope depends on plans and contracts, material volume, channels, vendors, agents and brokers; budget your staff time too.