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The new CMS Recording Rule (Final Rule)

July 8, 2022

On April 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released what they call a “final rule that advances CMS’ strategic vision of expanding access to affordable health care and improving health equity in Medicare Advantage (MA) and Part D through lower out-of-pocket prescription drug costs and improved consumer protections.”

  • Marketing and Communication Oversight
  • Lowering Beneficiary Pharmacy Costs
  • Verifying Past Plan Performance
  • Strengthening Network Adequacy
  • Creating Transparency in Medical Loss Ratio
  • Part C and D Quality Rating System
  • Enrollee Input in DSNP Operations
  • Social Determinants of Health and Special Needs Plan Health Risk Assessments
  • Simplified Appeals and Grievance Processes
  • New Pathways to Have Star Ratings Specific to the Performance of the Local D-SNP
  • New Pathways to Simplify D-SNP Enrollee Materials
  • Maximum Out-of-Pocket Policy for Dually Eligible Beneficiaries
  • Technical and Definitional Updates for FIDE SNPs and HIDE SNPs

The latest episode of Connect4Insurance has a more in-depth discussion on the full regulations.

How does the new CMS Recording Rule affect agents?

The National Association of Health Underwriters (NAHU), the leading advocate for health insurance agents, released an update as they continue to fight for change within the rule.  As it currently stands, beginning on October 1st, 2022, all field agents will be required to record all phone calls with beneficiaries.  There is also now a disclaimer that all agents must provide: verbally within the first minute of a sales phone call, electronically when communicating by email or other electronic means, or displayed on any third-party marketing materials or websites.  The disclaimer reads:

“I/We do not offer every plan available in your area. Please contact medicare.gov or 1-800-MEDICARE to get information on all your options”

What can an agent do to prepare or fight the new CMS Recording Rule?

There is a petition founded by Medicare agents trying to reach lawmakers within CMS to explain why the recording rule, while admirable, will negatively affect the wrong people.  According to the Federal Registry for 2022, CMS reported that there were only 39,617 “complaints to Medicare” out of 29,000,000 enrollments.  This equates to 0.0013661% of enrollments.  Most of the complaints were geared toward misleading television ads created by third-party marketing organizations that provide leads to call centers.  Sign the petition and register for your local NAHU chapter to make sure your voice is heard.

If the rule stands as-is, you need to be prepared.  We will have multiple options for recording calls, storing data, and identifying beneficiaries.  This is all provided at no cost.  Schedule a call with our National Sales Trainer, Rob Valincius, for more information on the technology available to you.

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For more information on Medicare OEP and one-on-one support.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Vice President | Health Sales

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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