Medicare Compliance Reminder

Medicare Compliance Reminder
New Medicare Advantage (MA) and Medicare Part D regulations related to Marketing and Communications

The Centers for Medicare & Medicaid Services (CMS) published it’s Final Rule revising the MA and Part D regulations related to, among other things, marketing and communications. The marketing and communications part of the Final Rule was designed to safeguarding Medicare beneficiaries and increase regulatory oversight for Third Party Marketing Organizations (TPMO’s). This revised regulation is effective now.

A TPMO is defined by CMS as an organization or individual, including independent agents and brokers who is compensated to perform lead generation, marketing, sales, and enrollment-related functions as part of the chain of enrollment. 

Below is a summary of the new Medicare Marketing and Communications Requirements

  • TPMO’s must add the following disclaimer to all communications: “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 or 1-800-MEDICARE to get information on all of your options” (verbally at the start of a sales call, on all electronic communications, prominently on your TPMO website, print materials, TV ads, etc.). 
  • TPMO’s must record all client sales calls in their entirety
  • TPMO’s must adhere to new submission guidelines for all marketing materials 

 Click Here for more guidance on the above summary.