The Centers for Medicare & Medicaid Services — the agency that oversees Medicare — is trying to make selling Medicare Advantage plans and Medicare Part D prescription drug plans much simpler for agents and brokers in 2027.
CMS announced Thursday, in a preview version of a final rule set to go into the Federal Register Monday, that it will overhaul the rules governing agents, brokers and other "third-party marketing organizations."
Some of the changes include:
◆ Eliminating a program rule that forced Medicare plan sellers to schedule Medicare seminars and Medicare sales meetings held at the same location at least 12 hours apart.
◆ Eliminating a requirement that an agent or broker let at least 48 hours pass between the time a Medicare plan sales prospect signs a "scope of appointment" form and has a personal meeting with the agent or broker.
◆ Shortening the period when agents and brokers keep recordings of the sales and marketing portions of calls with consumers to six years, from 10 years.
The sales meeting scheduling rule, for example, "was intended to protect beneficiaries from feeling pressured to stay for a marketing event after having attended an educational event," officials said in the preamble, or official introduction, to the final rule.
"However, it also created additional barriers for plans or agents/brokers as well as beneficiaries who wished to discuss potential enrollment options with respect to specific plan products following an educational event," they added.
All rules prohibiting high-pressure sales tactics still apply, and enrollees who have been misled about plans can switch to other plans, officials said.
Officials noted they shortened the call-recording retention period since a long retention period is burdensome and because very old calls are unlikely to help investigators deal with the current issues affecting Medicare plan enrollees.
In a regulation impact analysis section, CMS estimated that 100,000 agents and brokers sell Medicare plans.
Special enrollment periods: Normally, Medicare Advantage plan regulations prevent enrollees from switching plans between April 1 and Dec. 31.
Enrollees must qualify for special enrollment periods to switch plans after April 1.
In November, CMS proposed providing a special enrollment period for a Medicare plan enrollee if the enrollee's doctor left the enrollee's plan network in the middle of the year.
CMS did not say why it left that proposal out of the new final rule.
Other changes: In the new 2027 Medicare regulations final rule, CMS also:
◆ Eliminated a requirement for Medicare Advantage plans to include efforts to reduce health disparities in their quality improvement programs.
◆ Eliminated health equity requirements for Medicare Advantage plan utilization management committees, or plan teams that try to prevent unnecessary or overly expensive use of care.
◆ Prohibited Medicare plans from covering cannabis through special supplemental benefits for the chronically ill.
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