Referral Program

To be in compliance with Center Medicare and Medicare Services:

  40.4 – Nominal Gifts

  42 CFR §§ 422.2268(b)(1),(2),(12), 423.2268(b)(1),(2),(12)

Plans and Part D sponsors may offer nominal gifts ($15 or less, $75 aggregate, per person, per year) to beneficiaries for marketing purposes, provided the gift is given regardless of whether they enroll and without discrimination.

The following rules apply to nominal gifts:

If a nominal gift is a chance to receive one large gift or a communal experience (e.g., a concert, raffle, or drawing), the total fair market value must not exceed the nominal per-person value based on anticipated attendance. For example, if 10 people are expected to attend an event, the nominal gift may not be worth more than $150 ($15 for each of the 10 anticipated attendees). Anticipated attendance must be based on venue size, response rate, and/or advertisement circulation.

Nominal gifts may not be in the form of cash or other monetary rebates, even if their value is $15 or less.

Note: Plans and Part D sponsors should refer to the Office of Inspector General’s website for advisory opinions and guidance on gifts and gift cards.

  40.5 – Exclusion of Meals as a Nominal Gift

  42 CFR §§ 422.2268(b)(15), 423.2268(b)(15)

Plans and Part D sponsors may not provide or subsidize meals at sales or marketing events.

Refreshments and light snacks may be provided. Plans and Part D sponsors should ensure that items provided could not reasonably be considered a meal and/or that multiple items are not being “bundled” and provided as if a meal.

Meals may be provided at CMS-defined educational events and other events that would fall under the definition of communications (refer to Appendix 1).