The Centers for Medicare & Medicaid Services (CMS) recently released the Proposed Rule for Medicare Advantage (MA) and Part D for Contract Year 2027. For agents, agencies, and Medicare beneficiaries, the rule introduces a series of promising changes aimed at simplifying processes and reducing unnecessary regulatory burdens. While CMS’s press statements cover only a portion of these updates, the full proposal contains many important revisions that could significantly influence how agents operate and how consumers navigate their Medicare options.
To help you understand what’s ahead, this summary breaks down the most significant updates, explains why CMS is making these changes, and highlights their practical implications for both agents and beneficiaries.
Overall Direction for 2027: A Return to Simplicity
Right away, CMS signals a shift toward deregulation. Compared to the 714-page proposal released for 2026, this year’s 465-page rule is far more concise and purposefully streamlined. In fact, several policies introduced in the 2023 Final Rule would be rolled back, effectively restoring parts of the 2021 framework.
What this means: Beneficiaries should find it easier to learn about their Medicare options, while agents should experience fewer administrative hurdles. Put simply, the 2027 rule attempts to balance oversight with accessibility.
Top 8 Most Impactful Proposed Changes for 2027:
- Codifying Major Part D Changes from the Inflation Reduction Act
- Elimination of the 48-Hour Scope of Appointment (SOA) Waiting Period
- Allowance for One SOA to Cover Multiple Contacts + Inclusion of Permission-to-Contact
- SOA Required for All Personal Marketing Appointments – Not Only Scheduled Ones
- SOAs Can Once Again Be Collected at Educational Events
- Removal of the 12-Hour Separation Between Educational and Marketing Events
- Simplified TPMO Disclaimer Requirements and More Natural Phone Conversations
- Call Recording Retention Reduced from 10 Years to 6 Years
These changes, taken together, provide greater flexibility in how agents meet with clients, follow up with leads, host events, and communicate by phone.
Detailed Breakdown of Key Policy Shifts:
1.) Codifying Major Part D Changes from the Inflation Reduction Act
The Inflation Reduction Act of 2022 (IRA) introduced major reforms to the Medicare Part D prescription drug program and allowed CMS to roll out these updates through temporary program instructions through 2026. Because that temporary authority is set to expire, CMS is now proposing to formally write these changes into regulation for 2027 and all future years.
Under the proposal, CMS would officially adopt several major structural updates to the Part D benefit. These include removing the coverage gap phase entirely, lowering the annual out-of-pocket spending limit for beneficiaries, eliminating cost sharing for individuals who reach the catastrophic phase, and continuing the Manufacturer Discount Program, which replaced the former Coverage Gap Discount Program in 2025.
CMS is also proposing to codify several operational adjustments, such as revised True Out-of-Pocket (TrOOP) cost calculations, updates to specialty-tier requirements, changes to reinsurance payment methods, and the continued implementation of the Selected Drug Subsidy.
Taken together, these updates represent the most significant redesign of the Part D program since it began, to lower drug costs for beneficiaries while supporting long-term program stability.
For agents, these adjustments will require updated guidance conversations, since the redesigned Part D structure changes how costs progress throughout the year. Beneficiaries, meanwhile, would see lower and more stable drug expenses, clearer benefit phases, and no cost sharing once they reach the catastrophic threshold.
2.) CMS Proposes Removing the 48-Hour SOA Waiting Period
To start, CMS is once again proposing to eliminate the two-day delay between obtaining an SOA and conducting a personal marketing appointment. CMS reasons that the agency determined the rule created access barriers without offering measurable beneficiary protection.
Consequently, agents would be able to use same-day SOAs again, allowing beneficiaries to review plan options at the moment they’re most engaged.
3.) SOAs May Cover Multiple Appointments and Include Permission-to-Contact
Next, CMS would allow the SOA to serve dual purposes: granting permission to contact (PTC) and authorizing multiple discussions, provided the types of products are clearly noted. As a result, Business reply cards, online inquiry forms, voicemail requests, and other lead-generation tools could all function as legitimate SOAs if they list the product categories. This would mean that for beneficiaries, communication becomes smoother, with fewer repetitive forms to complete.
4.) SOAs Would Be Required for All Personal Marketing Appointments
Furthermore, CMS proposes requiring an SOA for any personal marketing encounter, including inbound calls, outbound calls, walk-ins, and virtual conversations. CMS also clarifies that a “small group” refers to individuals who are related or who live in the same household, which helps distinguish private marketing discussions from larger public events.
As a result, agents gain clear guidance on when an SOA is required (always, before discussing benefits), and beneficiaries know exactly what to expect from the start of any personal appointment.
5.) SOAs Allowed at Educational Events Once Again
In addition, CMS plans to rescind the prohibition on collecting SOAs during educational events, a rule that many in the industry found unnecessarily restrictive.CMS’s reasoning for this recession is that collecting SOAs at these events reduces barriers for individuals who want to take the next steps but may have difficulty reconnecting later.
This would tremendously benefit agents, allowing them to smoothly schedule follow-ups, and beneficiaries would gain immediate access to enrollment assistance.
6.) CMS Intends to Remove the 12-Hour Delay Between Educational & Marketing Events
Another significant rollback addresses event timing restrictions. CMS proposes removing the rule requiring a 12-hour gap between educational and marketing events held at the same location. However, transitions must still be clearly communicated, and attendees must be offered a break to leave if they do not wish to stay for marketing content.
The benefits of this rollback would be that agents can maximize space and time more efficiently, and beneficiaries can learn and enroll during the same visit, reducing travel and scheduling challenges.
7.) A More Streamlined TPMO Disclaimer
CMS also proposes simplifying the TPMO disclaimer by removing references to State Health Insurance Assistance Programs (SHIPs) and eliminating the “first-minute” requirement for phone calls. Instead, the disclaimer must simply be read before any discussion of benefits.
This change would allow for more natural, conversational phone interactions, reduce confusion for beneficiaries unfamiliar with SHIPs, and ultimately free up marketing space in printed and digital materials.
8.) Reduced Call Recording Retention Requirements
Finally, CMS proposes reducing the retention period for marketing and sales call recordings from 10 years to 6 years. The reason for this proposal is mostly because CMS rarely reviews calls older than six years, and audio storage can be costly. An agent can expect a significant reduction in long-term data storage obligations.
Additional Noteworthy Updates:
Beyond the headline changes, CMS also proposes several smaller but meaningful adjustments:
- Superlatives Allowed (With Conditions): Marketing superlatives may be used without immediate citations, though carriers must be able to substantiate claims when requested.
- Expanded SEP for Provider Terminations: CMS would rename and broaden the SEP that applies when a beneficiary’s provider leaves a network. This would make it easier for beneficiaries to switch plans when continuity of care is disrupted.
- Reduced Administrative Requirements: CMS proposes to exempt HRAs, FSAs, and HSAs from creditable coverage disclosures, remove mid-year supplemental benefit reminder notices, and ease LI NET’s call center availability requirements.
These changes aim to remove redundancies and modernize older mandates, further simplifying agents’ processes.
CMS Is Also Seeking Industry Feedback:
Importantly, CMS included multiple Requests for Information (RFIs) asking for public feedback on:
- The definition and categorization of TPMOs
- The 5% translation requirement
- Approval requirements for the Medicare Card image
- Outbound Enrollment Verification
- Testimonial rules
- Mailing statement regulations
This indicates CMS aims to address noncompliant behavior without imposing sweeping rules on agents who follow requirements. Comments may be submitted through CMS at: https://www.cms.gov/medicare-regulatory-relief-rfi
A Potentially Refreshingly Simplified Rule for 2027
Overall, the 2027 Proposed Rule takes a noticeable step toward reducing complexity in the Medicare Advantage and Part D ecosystem. By easing event restrictions, relaxing SOA requirements, simplifying disclaimers, and reducing administrative workloads, CMS appears to be prioritizing beneficiary access and agent efficiency.
If finalized as written, these changes could make the Medicare education and enrollment process smoother, faster, and more intuitive for everyone involved. The final rule is expected in spring 2026, and the industry will be watching closely to see which proposals are ultimately adopted.
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