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Life Health > Health Insurance > Medicare Planning

Medicare Advantage Agents Will Have to Record Calls by Oct. 1

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What You Need to Know

  • The Centers for Medicare and Medicaid Services now defines Medicare Advantage agents and brokers as TPMOs.
  • Starting Oct. 1, TPMOs will have to record all marketing calls with clients and prospects.
  • The right software tools can help with compliance.

New Centers for Medicare and Medicaid Services marketing rules will require agents to record Medicare Advantage and Part D Calls, starting Oct. 1.

What?

It appears that now agents and brokers are now TPMOs (third-part marketing organizations), which means they now are required to record all marketing calls with both clients and prospects where Medicare Advantage and Medicare Part D plans are discussed.

Concerning… maybe.

Challenging… could be.

A game stopper… for some. But it doesn’t have to be.

The Standard Disclaimer

How do you stay in compliance with these new call recording rules?

The right technology system can help.

Start with a system that displays the standardized CMS disclaimer, where appropriate.

Here’s the disclaimer:

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 Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Moreover, use a system that places the CMS required disclaimer, prominently, on any landing page, website or email sent by TPMO, or their “first tier, downstream or related” entities, or “FDRs.”

Other Compliance Strategies

Use a compliance system that:

  • Displays the required scope of appointment as a record for all marketing appointments via a recording for each CMS prospect.
  • Provides playbooks and talking points, that ensure that you offer Medicare Advantage and Medicare Part D prescription drug plan beneficiaries accurate and accessible, approved information about their health plan choices and benefits.
  • Ensures that you protect Medicare beneficiaries, by ensuring that the beneficiaries receive accurate and accessible approved information about their Medicare coverage.
  • Can confirm that beneficiaries understand the product, including the rules applicable under the enrolled plan by a recording of the call that shows the duration of each part of the conversation and the email confirmation provided after the call.
  • Supports the inclusion of multi-language inserts and scripts to inform beneficiaries.
  • Ensures, when applicable, that TPMs and Medicare Advantage organizations will disclose to the beneficiaries that their information will be provided to a licensed agent for future contact.

And make sure you use a system that can serve this process up both verbally, when you’re communicating through telephone with a beneficiary, and in writing, when you’re communicating through email, text or online chat.

If You’re an IMO…

If you run an independent marketing organization yourself, you need a system that can help you strengthen oversight of your own third-part marketing organizations, and that can  detect and prevent the use of confusing or potentially misleading activities to enroll beneficiaries in Medicare Advantage and Part D plans.

The system must also help you ensure performance compliance by Medicare Advantage organizations and FDRs in connection with any state investigation into an individual’s conduct.

You’ll need the ability to track TPMO marketing and lead-generation calls with beneficiaries, and that can give you reports on calls that fail to comply with the CMS standardized disclaimer guidelines.

Some platforms that provide some or all of these needed tools to ensure there is consistent compliance with the Calendar Year 2023 Medicare Advantage and Part D Final Rule (CMS-4192-F) are AgencyBloc.com, Hubspot.com and say2sell.com.

The clock is ticking, and that’s why agents should begin preparing to be in compliance by Oct. 1.


Lloyd Lofton (Photo: Lofton)Lloyd Lofton is the founder of Power Behind the Sales and the author of The Saleshero’s Guide To Handling Objections.

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(Image: bbernard/Shutterstock)