Compliance, Marketing, Medicare

Medicare Marketing Final Rule

Episode Summary

A recent episode of The Broker Link podcast provided an in-depth analysis of the new 2024 CMS final rule regarding Medicare marketing regulations. The hosts discussed the various changes agents will need to understand and prepare for to remain compliant during the 2024 Annual Enrollment Period and beyond.

One key change is the introduction of a 48-hour cooling-off period that will now be required before most appointments. The only exceptions are beneficiary-initiated walk-ins and appointments made in the 4 days leading up to the start of AEP. This change aims to protect beneficiaries from aggressive sales tactics. However, it may significantly disrupt call center models that rely on booking same-day appointments. Agents following these models will need to adapt their operations.

The final rule also clarifies that call recordings will only be mandatory for sales and enrollment conversations, not general educational conversations. This provides helpful guidance for organizations unsure if recordings were needed for non-sales calls. However, sales and enrollment calls will still require rigorous compliance with recording rules.

Several parts of the regulations remain ambiguous, especially regarding disclaimer requirements. The proposed rule's language around appropriate disclaimers left many agents confused about what statements would be mandatory. However, the final rule does not seem to add much clarity. This is one area where agents will need further guidance as 2024 approaches to avoid running afoul of unclear expectations.

Sharing of beneficiary contact information between third-party marketing organizations will also face major new restrictions. While this change aims to increase privacy protections, it could create complications for sales processes involving multiple partners. Careful coordination will be required to stay compliant.

In addition, educational events will now require a 12-hour cooling-off period before any sales activity can occur with attendees. The use of the Medicare name and logo will be tightly regulated through limits introduced in the new rules.

Overall, the hosts emphasized that agents will need to rigorously analyze how these changes will impact their current business practices. In particular, those relying heavily on quick-turnaround appointments or third-party lead sharing will require significant operational adjustments to avoid compliance violations and disruption.

Being aware of and prepared for these changes well in advance of 2024 will be critical. Waiting too long risks major struggles with adapting workflows and processes to the new rule set in time for AEP. Whether through training programs, compliance checklists, or expert guidance, proactive preparation starting now is the best way for agents to continue serving beneficiaries smoothly under the new marketing rules.


(0:00:04) - Gillan: Everyone had to make adjustments to Medicare marketing last year
(0:00:35) - Josh Slattery and Mike Smith talk about new CMS AEP regulations
(0:01:25) - Mike and Josh discuss proposed Medicare regulations ahead of 2023 AEP
(0:04:33) - So in your opinion, Josh, what would be the top two or three issues right now
(0:05:41) - CMS is adding a 48-hour cooling-off period for inbound calls
(0:10:30) - The new Medicare rules are subject to interpretation and may impact call center models
(0:14:44) - CMS is clarifying that call recordings need to be done in both processes
(0:18:33) - The disclaimer is very ambiguous as it's defined
(0:20:47) - I think this opens the door to lead aggregators abusing the system
(0:27:26) - The rule restricts the scope of appointments at educational events but lead cards are still allowed
(0:30:46) - If you're doing radio advertising or TV advertising and you have service area benefits
(0:34:22) - Mike and Josh have put together a great set of notes and takeaways

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