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Compliance lessons from Medicare’s “secret shoppers”

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It’s well known that Medicare Advantage and Prescription Drug Plans are tightly regulated products. So much so that the Centers for Medicare & Medicaid Services (CMS) has a surveillance plan in place to detect and correct non-compliant sales practices. As the 2012 annual election period nears its end, hopefully most agents will have followed the rules. Those that didn’t should tighten their sales practices for next year.

According to CMS, the major deficiencies uncovered were:

  • Failing to mention the products being sold at the beginning of the session.
  • Telling prospects they needed to provide personal contact information in order to attend the event.
  • Providing a sign-in sheet that wasn’t labeled “optional.”
  • Distributing sales kits that lacked the required language about future coverage availability.
  • Failing to mention availability of a low-income subsidy.
  • Using non-compliant language, such as promoting the availability of Canadian websites for buying discount medications.
  • Not verbally explaining which prescription drugs are covered.

Although the number of shopped marketing events increased 125 percent from the prior year, the number of serious problems decreased. That’s good news for the vast majority of agents who are selling these products “by the book.”