As we look forward to 2024, agents and Medicare Advantage and Part D plan beneficiaries should be aware of some major compliance changes coming their way. On April 5th, The Centers for Medicare & Medicaid Services (CMS) finalized its 2024 Rule, which outlines new regulations aimed at cracking down on deceptive sales practices and clarifying some of the newer regulations introduced in 2023. Changes from CMS will go into effect on September 30th, 2023.
The changes will impact agents in several ways, and it’s important for agents to understand the new rules to ensure compliance. We’ve outlined some of the most important highlights for you:
Additional Information Needed in the Mandatory TPMO Disclaimer
One of the changes is the mandatory inclusion of additional information in the TPMO disclaimer. The new disclaimer will include contact information for SHIP, the number of carriers an agent represents, and the total number of products available to beneficiaries. The language of the disclaimer will depend on whether an agent sells all MA and/or Part D plans within a service area or not.
Revised disclaimer for TPMOs that do not sell for all MA and/or Part D plans within a service area:
“We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”
Revised disclaimer for TPMOs that sell all MA and/or Part D plans within a service area:
“Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.”
Stricter Rules for Marketing Benefits
Another change concerns marketing benefits. Agents cannot advertise plan-specific benefits without including the name of the MA or Part D sponsor. Agents must also ensure that the plan they are advertising is available in the service area they are targeting and go through the HPMS filing and carrier opt-in process.
Removal of the Word “Medicare” in Business Name, Logo, or URL
CMS is also adding new rules to further restrict the usage of the Medicare name and logo in a way that could mislead beneficiaries into believing they are in contact with the federal government. Agents may not include the word “Medicare” in their business name, logo, or URL.
48 Hour Appointment Restriction for Signed SOA
Appointment setting is another area where agents will face new rules. Appointments may not be set prior to 48 hours of receiving a signed SOA, with some exceptions such as walk-ins and if the beneficiary is nearing the end of a valid enrollment period. Additionally, SOAs and BRCs are now valid for a 12-month period, and agents must keep track of the date they received them. If 12 months pass, agents will need to acquire renewed permission from the beneficiary to discuss plan details.
Record and Store Calls for 10 years
Virtual calls must also be recorded and stored for 10 years. CMS has clarified that virtual calls fall into the call-recording rule. However, this rule is limited only to marketing, sales, and enrollment calls.
Agents Cannot Set Appointments at Educational Events
Finally, agents cannot set appointments at educational events. The new rule restricts the distribution of SOAs and appointment setting at Medicare educational events, although the distribution of permission to contact cards, BRCs, and business cards is still allowed.
These rule changes will significantly impact Medicare Advantage and Part D agents. It’s important to stay informed and up to date on the new rules to ensure compliance and avoid any penalties or sanctions. Our team at Carolina Senior Marketing is here to answer any of your questions and help you move forward with your business as these rulings come into effect.
By working with a full-service insurance FMO like Carolina Senior Marketing, you will have a partner with attention to detail for compliance in your marketing and communications practices.