PIA, along with other agent groups, including the National Association of Health Underwriters, sent a letter to the Centers for Medicare and Medicaid Services (CMS) in response to its “Medicare Program: Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs,” which was finalized in May. The rule made significant changes to existing marketing requirements for both Medicare Advantage and Medicare Part D plans.
The final rule seeks to discourage dishonest marketing behaviors by requiring third-party marketing organizations (TPMOs) to record all enrollment conversations. However, traditional TPMOs are already required to record all enrollment conversations. The now-final rule dramatically broadens the definition of TPMO to impose an unnecessary burden on many entities that are acting responsibly, including individual agents and brokers, who will now be subject to the new recording requirement.
The new requirement will impose an additional demand on licensed agents attempting to assist Medicare beneficiaries in choosing suitable health and drug plans. The new regulation will discourage licensed agents and brokers from representing Medicare Advantage and Part D Plans until licensees develop compliant processes and procedures. For the foreseeable future, this will leave millions of Medicare beneficiaries without access to licensed assistance with the enrollment process.
Additionally, agents and brokers were excluded from stakeholder discussions during the rule’s development; as a result, it does not reflect the business practices of independent agents and brokers and their relationships with their clients. The letter urges CMS to delay the implementation of the new rule for six to 12 months, which would provide CMS with additional time to collaborate with the agent and broker community to refine the new marketing regulation so that it protects beneficiaries and still allows them access to trusted licensed independent agents and brokers.