The Centers for Medicaid and Medicare Services (CMS) regularly reviews existing and upcoming regulations for various Medicare Advantage plans, making it essential to keep abreast of these changes and understand how they impact beneficiaries. The recent ruling made on April 5th, 2023, regarding the 2024 Medicare Advantage and Prescription Drug Plans, focuses on Medicare communication and marketing compliance. The new regulation will take effect during the next AEP or plan year and will impact both beneficiaries and agents.
HERE ARE THE MAIN POINTS TO NOTE FROM THE LATEST RULE THAT WILL AFFECT YOUR BUSINESS:
48-hour Limitation on Scope of Appointment Time
CMS has reinstated the 48-hour rule for Scope of Appointment (SOA) meetings between agents and beneficiaries. There are exceptions for walk-ins and during the end of both the Annual Enrollment Period (AEP) and Open Enrollment Period (OEP). According to CMS, beneficiaries’ SOAs are valid for only six months after signing.
Marketing Requirements
CMS wants to ensure that beneficiaries have clear and effective communication with agents about their coverage. Please note that there are several other marketing requirements that aren’t included in the list below. Here are some of the significant changes noted in the recent ruling:
- No marketing events at the same location within 12 hours of an educational event.
- Limited use of the Medicare name, logo, and Medicare card.
- Prohibition of marketing plan benefits in areas where such benefits are unavailable.
- Marketing materials that focus on savings, specifically in comparison to typical expenses for uninsured individuals, unpaid costs of dually eligible beneficiaries, or other unrealized costs of a Medicare beneficiary, are prohibited.
- Prohibition of collecting SOA cards during educational events.
- Words like “most” or “best” when referring to Medicare assistance are prohibited in marketing materials (unless supported by data from the previous year).
The final ruling on Medicare Advantage and Prescription Drug Plans will be effective from June 5th, 2023, and apply to coverage starting from January 1, 2024. For more information, please refer to the full CMS ruling via the link below.
How Trusted American Can Help
At TAIA, we understand that keeping up with new regulations can be daunting and confusing. That’s why our team is dedicated to providing you with the most current Medicare information and assisting you in running your business compliantly. We are committed to helping you grow while also ensuring that Medicare beneficiaries receive the highest quality care possible.
For more assistance, please contact our Client Support Services at agents@taia.us, or 844-998-7878. We look forward to continuing to support you and your Medicare beneficiaries.