Are you tired of getting wrong or misleading information about Medicare? You’re not alone!
In response to a substantial increase in the number of Medicare beneficiary complaints associated with third-party marketing organizations that sell, or assist in the sale of Medicare plans, CMS (the Centers for Medicare & Medicaid Services) has revised the Medicare Advantage (Part C) program and Medicare Prescription Drug Benefit (Part D) program regulations.
Under this CMS Final Rule, which goes into effect Oct 1, 2022, third-party marketing organizations (TPMOs), including independent agents, brokers, organizations, and individuals, are required to record all phone* conversations related to Medicare Advantage Plans and Prescription Drug Plans in their entirety and store them in a HIPAA-compliant storage system for 10 years. This includes introductory calls to inform or educate clients about Medicare plans, as well as subsequent calls when the beneficiary makes an enrollment decision. Post-enrollment telephonic discussions must also be recorded.
• The agent/representative must tell you the call is being recorded, and
• Within the first 60 seconds, must provide the following 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 call 1-800-MEDICARE to get information on all of your options.”
If a person says they do not want their conversation to be recorded, the agent must end the phone call immediately. Applications submitted for beneficiaries who do not give permission to have their conversation recorded will not be considered valid enrollments by CMS.
Agents/individuals who are non-compliant with the Final Rule risk loss of licensure with their State and termination with their contracted health or drug plans.
* The audio portion of virtual meeting (via Zoom, Facetime, etc.) must also be recorded; conversations that take place in face-to-face meetings do NOT need to be recorded.