By
·
2 minute read
The memo highlights the following immediate actions they will be taking during the 2023 AEP to address these concerns:
- Enhancing CMS review of select marketing materials submitted under File & Use criteria. During AEP, CMS may exercise its authority to prohibit the distribution of File & Use materials prior to the expiration of the five-day plan waiting period. CMS may, at any time, determine an accepted material is not in compliance with our rules and require modification and resubmission.
- Reviewing selected marketing materials previously submitted under File & Use criteria.
- Reviewing all marketing complaints received during the AEP, and targeting their oversight and review on MA organizations and Part D sponsors with higher or increasing rates of complaints during the AEP.
- Reviewing recordings of agent and broker calls with potential enrollees.
- Continued secret shopping for marketing events by reviewing television, print, and internet marketing and calling related phone numbers and/or requesting information via online tools.
Upcoming Changes: Starting January 1, 2023, TV Advertisements will no longer go through the File and Use process in HPMS but will require a full, 45-day review by CMS prior to use.
As a reminder, we encourage all agents to use communication materials instead of marketing materials whenever possible. Both should be submitted to your upline for review prior to use and marketing materials should never be used until they have been reviewed and accepted by all carriers and have a Use Date assigned through the HPMS system.
Best Practices and Reminders for during AEP:
- A Scope of Appointment form is captured before speaking to a beneficiary regarding MA or Part D plans. SOAs are event specific so a new one should be captured each time you speak with a beneficiary if they do not enroll initially.
- All calls with beneficiaries must be recorded. This includes pre-enrollment, sales and enrollment, and post-enrollment calls, and recordings must be stored for a period of 10 years.
- The TPMO disclaimer must be read verbally at the start of each sales call (within the first 60 seconds) and must also be present on agent websites, email communications, and online chats.
- Marketing materials should not be misleading or confusing and must be compliant with all CMS and carrier guidelines, including all applicable disclaimers. Marketing materials must also be filed with CMS and opted-in by all carriers you represent prior to use.