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Advocacy in action blog

In May, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule which revises the Medicare Advantage (Part C) program and the Medicare Prescription Drug Benefit (Part D) program regulations to implement changes related to marketing and communications, past performance, Star Ratings, network adequacy, medical loss ratio reporting, special requirements during disasters or public emergencies, and pharmacy price concessions.

One area of concern is a new requirement which mandates contracts between TMPO and Plan, or TPMP and Plan’s FDR must ensure that the TPMO affirms that Medicare Advantage plans and Part D sponsors are responsible for TPMO activities associated with the selling of those plans and requires that TPMOs record all calls with beneficiaries in their entirety, including the enrollment process.

On balance, beneficiary dissatisfaction is not with their agent of record, but with the call centers that solicit beneficiaries to switch plans that may not meet their needs. NAIFA believes that calls with existing clients should be exempt from this requirement. To that end, we have been in contact with CMS and, on July 26, sent a letter to CMS Administrator Chiquita Brooks-LaSure requesting an exemption for agents working with existing clients.

Additionally, on August 11, NAIFA joined with joint trades partners and sent an agents coalition letter to CMS advocating for a rule implementation 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. 

In response to the outreach and concern about the lack of guidance on the recording of calls with clients, CMS has issued an FAQ to assist agents and brokers with navigating this new requirement. This new guidance provides an overview of the process and addresses some of NAIFA’s concerns regarding the lack of prior clarity. Many of the FAQs are based on questions NAIFA raised stressing issues many agents are having trying to comply. While the FAQs do not amend any of the recording requirements, this move is a positive step forward and possibly the first of other actions we could see CMS take.

NAIFA is continuing its collaboration with CMS, as well as working with federal legislators, requesting an exemption for agents and brokers working with clients. NAIFA will continue to press this issue with CMS and will provide updates as necessary.