The Biden-Harris Administration, through the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), has released the final part two guidance for the Medicare Prescription Payment Plan under the Inflation Reduction Act. This plan allows Medicare beneficiaries to spread their prescription drug costs over the year starting in 2025, capping annual out-of-pocket expenses at $2,000. The initiative aims to provide financial relief and prevent high upfront costs. CMS is also enhancing outreach and education to ensure beneficiaries are aware of these changes. These efforts complement other measures like the $35 insulin cap and expanded eligibility for the Extra Help program, further alleviating prescription drug costs for Medicare enrollees. View Press Release Fact Sheet For the fact sheet on the final part two guidance for the Medicare Prescription Payment Plan, please visit: https://www.cms.gov/files/document/fact-sheet-medicare-prescription-payment-plan-final-part-two-guidance.pdf Timeline For an updated implementation timeline for the Medicare Prescription Payment Plan, please visit: https://www.cms.gov/files/document/medicare-prescription-payment-plan-timeline.pdf |
Monday, May 9, 2022, was just an ordinary day for most individuals across the land. Now for those of us in the business of health insurance, we were presented with news that will change the dynamic of the entire industry.
On that day, the Centers for Medicare and Medicaid Services (CMS) released its 2023 Final Rule, and in this extensive document, there are two important guidelines we’d like to highlight in a more simplified manner.
New Required 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.” |
This disclaimer must be:
- Verbally conveyed within the first minute of a sales call.
- Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication.
- Prominently displayed on Third Party Marketing Organization (TPMO) websites.
- Included in any marketing materials, including print materials and television advertisements, developed, used or distributed by the TPMO.
Aside from that, this disclaimer needs to be added to any previously approved materials and resubmitted to CMS for approval.
Calls With Beneficiaries Must Be Recorded
Agents making calls to beneficiaries must record ALL calls in their entirety. In addition,
TPMOs must retain and make the recordings available upon request for a minimum of 10 years. You may ask, at which stage of the sales process or enrollment will a recording need to be started? Here is your answer.
This includes calls that are part of the chain of enrollment into a Medicare Advantage or
Part D Plan (the steps a beneficiary takes from becoming aware of a Medicare plan or plans to conducting enrollments over the phone), as well as post-enrollment telephonic discussions.
This rule applies to telephonic conversations only, not face-to-face meetings. The YourMedicare team was well aware of this change and immediately took action in
implementing the resources needed to comply with these new requirements.
The YourMedicare Sunfire Solution (Request access here) |
Introducing the YourMedicareSunFire Integrated Telephony System. This addition to our state-of-the-art online enrollment tool will not only assist agents during the sales process but also help to keep them completely compliant with Medicare Advantage and Prescription Drug Plan enrollments. INBOUND & OUTBOUND DIALING The YourMedicareSunFire Integrated Telephony System provides a virtual phone RECORDING & STORAGE The platform saves recorded conversations in a safe and HIPPA-compliant manner for the minimum of 10 years. Agents will have various available storage options, based on the outcome of the call. Record, save and store all in one spot! REQUIRED DISCLOSURES The YourMedicareSunFire Integrated Telephony System displays integrated |
This is just the beginning of what is to come. As new information becomes available, we’ll keep you updated on all new enhancements, news and more specific details
relating to the 2023 CMS Final Rule and the YourMedicareSunFire recording functions.
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