New CMS Call Recording Requirements for Insurance Providers

The Center for Medicaid and Medicare Service (CMS) has issued some new major changes to the compliance rules and guidelines that will apply to Medicare Advantage and Part D plans. The new CMS call recording requirements will apply to all independent insurance agents and are set to take effect starting in 2023.

All insurance agents will be required to:

• Record all calls with their beneficiaries,
• Store all recorded calls for ten years,
• Every call with a beneficiary must include the following disclaimer:
  “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 of your options.”
• The requirement for this disclosure applies to all interactions across all types of communication with a beneficiary, including during a sales call, an email, on a website, online chats, and any and all marketing materials aimed at Medicare Advantage and Part D beneficiaries.

Although the effective date for the new guidelines is 2023, the Annual Enrollment Period for Medicare recipients takes place from October 15th to December 7th, 2022. Adherence, according to the new guidelines, should start from the beginning of when the beneficiary becomes aware of a plan through the end of enrollment. Basically, adherence should start at the beginning of the new enrollment period ahead of 2023.

About Call Recording Requirements

Third-Party Marketing Organizations, meaning independent agents and brokers, must record all calls with beneficiaries included in the chain of enrollment, including the enrollment itself. CMS describes the chain of enrollment as the events from a beneficiary becoming aware of an MA/PDP plan to the end of the enrollment process.

Each call included as part of the chain of enrollment must be recorded from beginning to end and prompt call participants that the call is being recorded. The prompt notifying the potential enrollee should also be recorded as proof that it happened within the first minute of the call.

All the following call types are considered a part of the chain of enrollment, and they must be recorded and stored:

• Calling leads,
• Collecting scopes of appointments telephonically,
• Presenting plans,
• Discussing different plans if an individual wants to switch,
• Collecting prescription drug lists and physician lists,
• Mid-year policy reviews,
• Educational discussion of Medicare options,
• Annual check-ins,
• Telephonic enrollments, and 
• Marketing calls.
  
  

About The Disclaimer

The disclosure must be provided in more than just your call communications but must also be included in the following:

• Electronically, when communicating with a beneficiary through email, online chat, or other electronic communication,
• Prominently on your website and/or
• Visually on all marketing materials that you create, utilize, and/or distribute.

To be clear, whenever there is a question of whether you should include the disclaimer, include the disclaimer. The ONLY scenarios where you are NOT required to share the disclaimer would include the following:

• In-person meetings with a beneficiary,
• If you only sell plans on behalf of a single carrier, and
• If you sell all commercially available MA or PDPs in a given service area (the least common scenario)

With MiaRec's Recording Announcement For Cisco platforms, you can eliminate the possibility of human error and know rest assured you will always stay compliant in any call scenario on Cisco platforms, including both inbound and outbound calls.

Complying with the New CMS Rule Changes

CMS occasionally adds new rules and regulations as they see fit to better meet the needs of Medicare enrollees. The right solution and software provider can help you comply with these rules by safely recording, storing, and ensuring compliance with all the new regulations including disclaimers.

Contact us or visit us at MiaRec.com to learn more about how MiaRec can help.

***The information provided on this website does not, and is not intended to, constitute legal advice. All information, content, and materials available on this site are for general informational purposes only.