Benefits Buzz

New Medicare Marketing & Sales Rules for 2023

Posted on September 7th, 2022

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) published some new compliance rules that will impact Third-Party Marketing Organizations (TPMOs) who sell Medicare Advantage and/or Part D plans. The definition of a TPMO includes independent agents and brokers who are compensated for selling Medicare products. There are two new compliance rules that are of particular importance.
Required Disclaimer
The first new rule requires a new disclaimer to be communicated to Medicare beneficiaries. The disclaimer must say, “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all of your options.”
The disclaimer must be 1) verbally stated during the first minute of a sales call, 2) electronically conveyed when communicating with a Medicare beneficiary through email, online chat, or any other electronic means, 3) prominently displayed on agent or broker websites, and 4) included in any marketing materials, such as printed materials or television advertisements. The disclaimer is not required if an agent or broker does represent all Medicare plans in a given service area, but it will typically be unlikely that an agent or broker does represent all Medicare plans for various reasons.
Recording Sales Calls
The second requirement will be somewhat burdensome to many agents and brokers. It requires agents and brokers to record (and retain copies) all phone calls that are part of the “chain of enrollment.” Any phone call that involves lead generation, marketing, sales, and enrollment related functions must be recorded. If the call involves any steps taken by a Medicare beneficiary from becoming aware of a Medicare plan all the way to making an enrollment decision, the call must be recorded.
Some examples of calls that will need to be recorded include 1) calling on a lead who has requested to be contacted, 2) scheduling an appointment to meet with a prospective client, 3) discussing plan specific details, 4) reviewing covered drugs and in-network providers, 5) collecting or documenting scope of appointment forms, 6) and performing a telephonic enrollment. It seems that most calls will need to be recorded by agents and brokers.
The new compliance rules apply to any Medicare Advantage or Part D plan that has an effective date on or after January 1, 2023. Agents and brokers can begin discussing 2023 plans with prospective clients as early as October 1, 2022, so these new requirements are quickly approaching.

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