We all experienced major compliance changes last year, including mandatory call recording and a new TPMO disclaimer. CMS has released its proposal for the next round of compliance rule updates, which would include bringing back the 48-hour Scope of Appointment (SOA) rule and lengthening the TPMO disclaimer.
Here's a quick look at some proposed compliance changes that may be effective for 2024 plans. Please keep in mind these rules are not final.
While there are many proposed changes in the 2024 Proposed Rule, one of the most notable is bringing back the 48-hour SOA rule.
CMS would require you to obtain an SOA at least 48 hours before your personal marketing appointment. In other words, you couldn't have a potential enrollee sign the scope and immediately begin their appointment. You'd have to wait two full days to move forward with that appointment.
In addition, if these rules are finalized, that SOA would only be valid for six months after the person signed it.
Longer TPMO Disclaimer
You're likely familiar with the newly required TPMO 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.
In the proposed rule, this disclaimer would get longer, as you would now be required to list every MA and PDP carrier you're contracted with. It also would need to include that beneficiaries can get information from SHIPs.
Here's what the revised disclaimer would look like:
“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 which are [insert list of MA and Part D carriers]. Please contact Medicare.gov, 1-800-MEDICARE or your local State Health Insurance Program to get information on all of your options.”
Sales Presentation Rules
Some agents hold educational events and then do sales activities afterwards. As an example, after an educational Medicare seminar, an agent might hold a sales presentation or schedule a future marketing appointment.
In the CMS Proposed Rule, this would be prohibited. Marketing events would not be able to take place within 12 hours of an educational event at the same location (defined as the whole building and adjacent buildings).
In addition, you would not be allowed to set up future marketing appointments or collect beneficiary contact information – including SOAs – at educational events.
Call Recording Updates
The new call recording requirement was definitely a big change for a lot of us, but it looks like the rules may ease up slightly for plan year 2024 marketing.
CMS would limit calls that must be recorded to sales, marketing, and enrollment activities. That means you may not have to record appointment-setting calls or after-sale check-ins.
Another addition is a clarification that videoconferences would need to be recorded (such as Zoom, FaceTime, or Skype calls).
Finally, if the proposed rule is finalized, CMS would require sales calls to discuss a list of required CMS topics or questions, like PCPs, specialists, and drug coverage and costs.
Download a Summary
In addition to the most notable compliance changes already mentioned, there are a few more marketing provisions.
Some examples include not being able to market benefits if they're not available in that service area and not being able to advertise benefits unless you name the MA organization or PDP sponsor.
You can get a downloadable version of the proposed compliance changes here.
Compliance changes can be frustrating, but we are here to help you. We'll continue to educate you about finalized changes and we have plenty of tools to make adhering to these changes simple and hassle-free.
If you are interested in discussing MA options in your area, please don't hesitate to schedule a call with me. Good selling!