A CMS rule revising Medicare Advantage and Part D marketing and communication regulations went into effect June 28 to increase oversight over third-party marketing organizations.

Medicare Advantage and Medicare Part D plan sponsors must comply with the new CMS rule first put forth on May 9. 

Six things to know:

  • TPMOs are now defined as “organizations and individuals, including independent agents and brokers, that are compensated to perform lead generation, marketing, sales and any enrollment-related functions as part of the chain of enrollment.”  
  • TPMOs must display a disclaimer that says, “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 must also be given verbally, electronically or in writing, unless the TPMO explains every plan available
  • Plan sponsors will be responsible for making sure all TPMOs follow the requirements.
  • Plan sponsors and their subcontractors must require TPMOs to disclose any applicable subcontracted relationships.
  • Plan sponsors must ensure that TPMOs notify members of the TPMOs’ role.
  • Plan sponsors must have oversight over any company performing marketing services on their behalf and must document that oversight, along with any actions taken against TPMOs not compliant. Failure to do so could result in financial or operational penalties.
  • Agent/Brokers assisting beneficiaries via phone or video, must record all calls in its entirety. During the first seconds of the call he/she must provide the disclaimer, listed above in bullet point 2.

Source: Becker Payers Issue

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