CMS Ruling on Disclaimer & Recorded Calls

TPMOs must use the standardized disclaimer codified in CFR 42 § 422.2267(e)(41) and §423.2267(e)(41).

The disclaimer required states: ‘‘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.’’

This disclaimer would be required on any marketing materials and websites used by AmeriLife, and stated verbally or in writing. The new disclaimer language will require AmeriLife to update and/or modify its messaging to consumers. This may entail revamping and approvals from carrier partners on all marketing materials prior to use.

All agents are required to record and store all Medicare Advantage and PDP enrollment related calls per CFR Section 42 § 422.2274(g) and § 423.2274(g)

At this time, this requirement includes all agents and would be applicable to new and existing customers. The rule references marketing calls, which is interpreted by CMS to include enrollments. The only enrollments that do not need to be recorded are in person (face-to-face). However, if an agent walks a consumer through an online enrollment (even while sitting in the home), it must be recorded. Storage would be required for 10 years.

All agents should make preparations for recording and storage of all inbound and outbound calls.

AGENT TOOLS:

CLICK HERE For information about TAPEACALL PRO and Automatic Call Recorder Apps to download on your cell phone.

CLICK HERE For information about Yourmedicarebot a resource for Field/Hybrid e-enrollments

WHY?

The definition of TPMOs was defined in CFR Section 42 § 422.2260 and § 423.2260 as organizations and individuals, including independent agents and brokers, who are compensated to perform lead generation, marketing sales, and enrollment related functions as a part of the chain of enrollment.

Who are TPMOs?

• First Tier
• Downstream
• Related Entities

TPMOs may be a first tier, downstream or related entity (FDR), but can also be entities that are not FDRs but provide services to an MA plan or an MA plan’s FDR.

NOW INCLUDED:  Independent agents and brokers are now included as a TMPO.  According to CMS, there has been an increase in the number of alleged complaints that beneficiaries may be mislead about advertised benefits.