New compliance rules and guidelines that apply to Medicare Advantage and Part D plans are coming. From new disclaimers to a call recording and 10-year storage requirement, these major changes will affect all independent insurance agents this AEP.
Here's everything you need to know about the upcoming CMS compliance changes, including solutions that will be baked right into MedicareCENTER.
Disclaimer: The information in this article is how we interpret the new CMS compliance rules and guidelines. If any more details or clarifications are made available, we will update you as soon as possible.
CMS rolled out a lot of compliance changes that apply to all plan enrollments with a 2023 effective date.
The changes that will affect you, the agent, the most include:
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.”
Since AEP is the start of marketing for plan year 2023 enrollments, you should start adhering to the new CMS compliance changes beginning on October 1, 2022.
Within the first minute of any call with a beneficiary, you must verbally provide this new 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.”
You must also provide the disclaimer in these other areas:
When in doubt, include the disclaimer.
You are not required to use this disclaimer for in-person meetings with a beneficiary, if you only sell plans on behalf of one carrier, or if you truly sell all commercially available MA or PDPs in a given service area (very, very unlikely).
Independent agents and brokers are considered third-party marketing organizations (TPMOs). As such, you now must record all calls with beneficiaries in their entirety – including the enrollment. You also need to inform the individual that the call is being recorded.
Ensure your call is recording when you verbally inform the individual that the call is being recorded. You'll also need proof that you recited the disclaimer within the first minute of the sales call.
All inbound and outbound calls along the full "chain of enrollment" must be recorded.
Chain of enrollment definition: the events from a beneficiary becoming aware of an MA/PDP plan to the end of the enrollment process.
All of the following call types are considered a part of the chain of enrollment, and they must be recorded and stored:
We have great news for you — Integrity is building a call recording capability into MedicareCENTER.
This convenient and easy-to-use call recording technology will be FREE for all Integrity partners and their downline independent agents and brokers.
Another huge responsibility is storing your recorded calls for the required 10 years. Where do you store them, and how do you know the storage solution is HIPAA compliant and secure?
Here’s more great news — MedicareCENTER will have the capability to store call recordings for 10 years. If you choose to use a different call recording resource, make sure it provides you with 10-year access to all your call recordings.
While these new compliance rules and guidelines are a big change, MedicareCENTER makes it easy.
In advance of AEP, MedicareCENTER will be able to handle:
Be sure to download our new Agent FAQs document to learn more about these compliance changes.
We will be sharing more information and agent training materials leading up to AEP, so please be sure you subscribe to our email newsletter!