CMS released an FAQ document regarding marketing and communications requirements for the Part C and Part D programs. The FAQs seek to clarify rules issued by CMS in the 2023 Medicare Advantage and Prescription Drug Benefit final rule that caused industry confusion.

On May 9, 2022, CMS published its contract year 2023 Medicare Advantage and Prescription Drug Benefit Final Rule (87 FR 27704), where CMS established certain marketing and communications requirements for the Part C and Part D programs in an effort to address complaints of inappropriate marketing from patients and caregivers. CMS explained that it has received questions regarding these changes, including requirements related to recording calls between beneficiaries and Third-Party Marketing Organizations (TPMOs). Accordingly, CMS released an FAQ document to clarify certain rules. Key points include:

• All organizations and individuals that fall under the definition of TPMO as defined in 42 CFR §§ 422.2260 and § 423.2260 must record calls with beneficiaries.
• All calls with enrollees, even calls that are outside the scope of the chain of enrollment, must be recorded.
• This includes inbound and outbound calls, as well as calls through virtual platforms such as Zoom.
• If a beneficiary refuses for the call to be recorded, the call must end.
• The call recording requirement was effective as of October 1, 2022, for plan years beginning January 1, 2023.
• Retention requirements depend on the nature of the call. The CMS requirement to maintain certain records for ten years applies to all calls between beneficiaries and plans, including TPMOs, that pertain to the sales and enrollment processes.

The FAQ document is available here.