09/27/2022
New Medicare regulation does not help individuals better understand Medicare!
Background: In response to the large number of complaints they were receiving from all the individuals misled by all the TV ads with celebrity spokespersons saying “call now for new benefits!” the Center for Medicare and Medicaid Services (CMS), which runs Medicare decided the way to eliminate these complaints was to expand an existing regulation. It states:
When a person calls a Medicare Plan company or a Third Party Marketing Organizations (TPMO) about a Medicare Advantage or Prescription Drug Plan and then decides to enroll in a specific plan, they are asked to approve recording the completing the application.
Now effective October 1st all Medicare Health Plan Professionals are required to record any and all telephone calls with current clients or others about Medicare. Professional Medicare Health Plan Advisors, when on the telephone with a Medicare beneficiary focus on simplifying and increasing understanding thus, do so much more than complete an application. They have detailed conversations and answer questions on things such as how:
+ to sign up for Medicare,
+ Medicare’s Part A & Part B work,
+ the two different types of plans, which are available to cover the part of their treatments Medicare does not pay, work.
These conversations usually bring out lots of details on the individual’s situation and interests followed by a review of plans in their area. If the individual selects a plan to fit their budget and situation, then lots of details and information on the plan is provided.
Note: Recording all telephone conversations does not help individuals or increase understanding of how Medicare and the health plans work!
Asking a person as soon as they begin a telephone conversation to talk about Medicare Plans to approve the recording of their discussions is significantly different than approving a recording on filling out an application form. Individuals also have to OK the fact that the recording will be retained for 10 years!
Note: Recording a discussion of a individual’s personal information does not help them in any way and does not go over well with many.
I certainly do not understand how creating this “crazy” requirement will eliminate these complaints! What should have been done is investigate the TPMOs, which create the TV ads about why they were not following current marketing rules.
Lots of effort has been going on by the National Association of Health Underwriters, my professional association focused on Medicare, to ask CMS to modify the expanded definition of who is a TPMO. This effort was recently featured in an Inside Health Policy article. The details can be found here. Hopefully you will review.
CMS confirms it has no plans to delay implementation of the 2023 Medicare Advantage and Part D final rule that cracks down on aggressive MA marketing tactics, despite calls to do so from health insurance agents and brokers who object to being included in the definition of a third-party marketing org...