After 14 years of monitoring Medicare marketing across hundreds of millions of pages, we have a pretty good sense of which violations show up over and over again. They are not exotic. They are not obscure edge cases. They are the same problems, in the same places, across plans of every size.

Here are the ten CMS marketing violations we find most often in Medicare advertising.

The Ones That Show Up Every Week

1. Unapproved Materials in Active Distribution

This is number one for a reason. A version of a flyer, ad, or landing page that was never submitted to CMS HPMS — or was submitted and not approved — is live somewhere in the distribution network. The agent thinks it was approved. Nobody checked. CMS cares about what beneficiaries actually see, not what was in the submission queue.

2. Missing or Incomplete Required Disclosures

“We accept all Medicare-approved providers” sounds fine until you realize the plan has a network and disclosure language is wrong. Required disclosure language under 42 CFR § 422.2267 is specific. “Generally similar” doesn’t pass.

3. Misleading Benefit Comparisons

Ads that imply a Medicare Advantage plan covers something Original Medicare doesn’t — without clearly stating the limitations — are consisently flagged in CMS audits. Benefit comparisons have to be accurate, complete, and not structured to confuse.

4. Failure to Display Required CMS Disclaimer Language

Every piece of Medicare marketing has to include the CMS-required disclaimer that the plan is not connected with or endorsed by the U.S. government or the federal Medicare program. It gets dropped. It gets buried in 6-point type. Both are violations.

5. Star Ratings Misuse

Plans cannot reference their Star rating in marketing unless the rating meets CMS thresholds, and they cannot imply their rating is higher than it is or use outdated ratings. We find expired Star rating claims in active ads regularly.

The Ones That Come from Agents and TPMOs

6. Failure to Follow Sales Event Rules

CMS secret-shopper results from 2024 and 2025 show agents routinely failing to disclose the Medicare Part B premium obligation, explain Late Enrollment Penalties, or note plan Star ratings during formal sales events. All required. All commonly skipped. The violation lands on the plan sponsor.

7. Marketing in the Wrong Enrollment Period

Soliciting beneficiaries outside of permitted enrollment periods — or implying that enrollment is available when it isn’t — is a recurring problem in digital advertising, especially with evergreen ad campaigns that don’t get updated.

8. Nominal Gift Violations

The limit on gifts to beneficiaries is $15 per item and $75 annually. Nominal gifts above those thresholds at sales events are violations. This one trips up agents who think gift cards are fine because everyone does it.

9. Unsolicited Contact

Cold calls, unsolicited door-to-door visits, and emails to beneficiaries who did not request contact are prohibited under CMS marketing rules. Lead generation practices that blur this line — especially when TPMOs are involved — generate violations that trace back to the plan.

10. Unapproved Multi-Plan Materials

When a TPMO creates materials promoting more than one plan, those materials require CMS HPMS approval before use. They often don’t get it. They go out anyway. We find them.

What These Violations Have in Common

None of these are complicated rules. They are not buried in regulatory footnotes. They are the CMS marketing rules that every plan and every agent should know cold.

What they have in common is that they happen in distribution — after approval, after contracting, after the compliance team signed off. The materials that got approved are not always the materials that get used. The agents who passed training are not always following it in the field.

The only way to catch violations at this stage is to monitor what’s actually in market. That is what IntegriShield does. We monitor 100M+ pages per month across every consumer-facing channel and eliminate 100% of client review burden thorugh full-service remediation. When we find a violation, we handle it — our clients don’t have to chase it down themselves.

If any of these ten sound familiar, it’s worth having a conversation.

Find us at integrishield.com.