Largely because of the “Joe Namath” television ads that have been appearing, consumer complaints about misrepresentation of Medicare Advantage and Part D Prescription drug plans have increased about 250% in the past year. A large portion of these complaints are against the call centers that these ads ask Medicare beneficiaries to call for more information. These call centers already record telephone calls.
CMS (the agency that administers Medicare) has issued guidelines that will be effective October 1 concerning marketing of Medicare Advantage and Part D drug plans with effective dates of January 1, 2023 or later. Under these guidelines, independent agents will be considered “third party marketing organizations” and will be subject to a requirement to record all telephone calls where there’s a discussion about premiums, benefits, or co-payments. Recording requirements won’t apply in situations where there's an in-home appointment or in formal or informal sales presentations.
Agents are seeking clarification concerning what the exact requirements are and are also seeking to have CMS postpone or eliminate the requirement. The argument is that CMS is punishing independent agents who in most cases follow all the rules, that these rules will create hardships for beneficiaries who want to discuss plans by phone and don’t want in-home meetings, and that it’s difficult to obtain recording software that meets HIPAA requirements (e.g. for encryption) and the ten year-retention requirement that also applies to Scope of Appointment forms.
The new recording requirement doesn’t apply to emails, BUT it's very difficult to have an email discussion about benefits, premiums or co-payments because of the detail that’s involved in discussing these matters.
In today’s climate many clients and potential clients don’t want to have in-person appointments and prefer to talk with agents telephonically.
Many insurance carriers oppose these requirements, claim that independent agents are not "third party marketing organizations," and we've been advised they've scheduled a meeting with CMS to discuss their opposition to these requirements. Also, the National Association of Health Underwriters (NAHU) has been communicating with CMS about changing the effective date and/or eliminating the recording requirement, but so far all efforts seeking a change to the requirements have been unsuccessful. Accordingly, we're exploring methodologies for recording calls in case this requirement is not changed, delayed, or eliminated.
Also, there are few situations where independent agents represent ALL Medicare Advantage and Part D carriers in a particular zip code, particularly in a state like Florida. Starting October 1 CMS has also made it a requirement that an independent agent must read a disclosure requirement that s/he does not offer all available plans. This statement must be read verbatim in the first minute of a sales call with a client or potential client.
We’re waiting for clarification and more specifics regarding these new requirements. As of now, these requirements will apply to all call centers and all independent agents. Unfortunately, there are some call centers and and a few independent agents who don’t follow all the Medicare Marketing Guidelines, but we intend to be in compliance and follow carrier and CMS guidance once all requirements are identified and clarified.
These requirements do NOT apply to Medicare Supplement plans.
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