CMS Call Recording Requirements

CMS Call Recording Requirements

CMS call recording requirements for insurance agents are a result of the CMS Final Rule set for October 1, 2022.  The rule expands the definition of who is a TPMO to include independent Medicare agents, agencies and brokers. The rules are applicable to MA/MAPD and Part D products.  Because CMS does not regulate Medicare supplement products, CMS does not include them in the new rule.  TPMO stands for Third Party Marketing Organization and now includes NMO’s, FMO’s, agencies, brokerage, independent agents and brokers.   This blog will provide an outline of the changes from the Final Rule and also how agents can be compliant with them for the 2023 AEP.

The new rules

The new rules are applicable to all TPMO’s.  The definition of a TPMO has been expanded to include both independent agents and agencies. Agents need to be compliant with the new rules by October 1, 2022.  Here are the main points to know:

• Record all calls with Medicare beneficiaries in their entirety, including the enrollment call. The rule is including the entire “chain of enrollment” which requires agents to record inbound and outbound calls, enrollments calls and any calls leading up to the enrollment and post enrollment.  (If the call is going to lead to a Medicare Advantage or PDP or the attempt to make a sale)  The recording must be available for 10 years
• The addition of a TPMO disclaimer on enrollment phone calls and any marketing materials;  the agent must state the TPMO disclaimer within the first minute of the enrollment/sales call.
• TPMO disclaimer must also be displayed on all Medicare marketing materials (Not Medicare supplements) which includes emails, websites, newspaper ads, flyers, mailers or any other promotional advertising method
• NOTE:  Call recording is NOT required when meeting for a face to face meeting.  There is also no recording requirement for educational events
• Zoom Calls:  Some carriers are stating Zoom calls are a face to face meetings.  (CMS is stating Zoom calls are not face to face and recording is needed)

CMS call recording requirements: The TPMO disclaimer

Here is the disclaimer which must be used for sales calls and on all marketing materials as well as all marketing communications:

“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 options.”

Immediate steps for agents

Take the following steps to be compliant with the new rule for October 1, 2022.

• Add the TPMO disclaimer to your website
• Have the TPMO disclaimer on all email communications
• Easiest way is to add the disclaimer to your email signature line
• Add TPMO disclaimer to all marketing materials including print and TV ads.
• Use an enrollment platform that can record calls and keep them for the required 10 years  (We offer Connecture, Sunfire and MyMedicareBot at no cost)
• If you do not have access to an enrollment platform, add a service to record all calls at the office or home.  Many companies offer the service at a surprisingly low cost ($25 to $45 a month).

Connecture, Sunfire and MedicareBot offer call recording and 10 year recording storage at no cost to our agents! Learn about all three systems and watch 3 minute demonstration videos of the call solutions for each

CMS Call Recording Requirements:  Other questions and rule enforcement

Many agents are asking if they need to record all calls vs. recording only the enrollment calls.  The CMS rules make it clear; the expectation is to record all calls in the “chain of enrollment”.  This means you should record all calls leading up to the sale.  This includes the sale as well as post enrollment calls.  The unanswered question is;  how will CMS regulate it. It is reasonable to assume the carriers (They ensure compliance of CMS rules for TPMO’s) will only ask for the actual enrollment call when doing compliance checks.  Keep in mind; this is not guaranteed, so the way to be sure of 100% compliance is to record all calls.  There will likely be many agents that record the sales/enrollment call only.  Only time will tell if that is enough to stay in good standing with compliance checks.

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