The Centers for Medicare and Medicaid Services (CMS) recently finalized its updated Medicare Program: Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs. The rule made significant changes to existing marketing requirements for both Medicare Advantage and Medicare Part D plans. PIA, along with other agent groups, strongly opposed this final rule.
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 be subject to this new recording requirement.
The new requirement imposes an additional demand on licensed agents attempting to assist Medicare beneficiaries in choosing suitable health care and prescription drug plans. The new regulation will discourage licensed agents and brokers from representing Medicare Advantage and Part D Plans until they can develop compliant processes and procedures. For the foreseeable future, this could leave millions of Medicare beneficiaries without access to the assistance with the enrollment process that can only be provided by licensed professionals.
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.
Send a message to Congress that urges them to request that HHS implement a delay of six to 12 months, during which CMS will work with stakeholders to develop marketing regulations that will protect beneficiaries while allowing them access to their trusted licensed independent agent or broker. Click here to take action today!