New Regulations

I just read what feels like my 9 millionth comment and post about the compliance changes, and I want to take a minute to educate you on why it’s just not that easy to make this all be better. Hopefully it’s enough for you to understand and maybe, just maybe, help with the solution. Because there ARE ways you can help.

Everyone knows that the call-center agencies and lead vendors using foreign call centers are the source of the majority of the CMS complaints. When the seniors call to complain, the reason they are filing the complaint is because they think they are talking to Medicare and Medicare is changing their plan.

Now, on the back side of this, the Departments of Insurance and CMS — Medicare — when they get these calls, only have ONE option to file it under, and that puts the independent insurance agent AND these call centers in one bucket. So when CMS in February proposed the changes for 2023 and ran the reports, they saw a spike in the complaints and, candidly, people who really don’t understand what we do and how we do it made a broad-stroke decision to change the definition of what a TPMO (Third Party Marketing Organization) is, and proposed a rule to try and prevent these seniors from thinking they were talking to Medicare. In May, the final rule was issued for the 2023 year. Once that rule is in place, it is set and takes a lot to change it.

When the verbiage of the Final Rule came out, the lawyers from all of the carriers and CMS put their spin on what “ensuring” that the disclaimer was given within 60 seconds meant. So many questions. And candidly, CMS didn’t think through how the rule would affect the smaller-sized agent who doesn’t already have recording systems in place. Call centers have had this requirement for years and didn’t think it would be such a hardship. They thought wrong.

So the professional organizations like NAHU, NAIFA and AHIP started asking for clarifications, and so did the carriers. Except the answers weren’t consistent. Now CMS is drafting clarification on what needs to be recorded, but the requirement will NOT entirely go away. This wasn’t designed to magically stop all the illegal calls. It was designed to help with gramma thinking that she was talking to Medicare (and it probably won’t) — but we need to comply, and there are actually benefits for us with this, since the people we are working with are known to be losing their memory.

Anyway, so what can you do? Right now, the best thing you can do is talk to your Congressman or Senator and explain that lumping the Independent Agent in with the call centers under the TPMO definition makes no sense, and we need to be viewed as our own separate channel. We want the TPMO definition updated to NOT include us. There is a team that has been actively working on this for weeks and months now.

Next, get active locally with one of your professional organizations! Share your stories. Real-life examples and the outcomes. We NEED those to help paint both the VALUE OF WHAT WE DO and what needs to be changed. Complaining on Facebook or other social-media platforms will not help. But getting involved and using your voice for your livelihood will. You’ll be amazed at the contacts you meet and the education you’ll receive while getting involved, too! Guys, NOW is the time. You are NOT HELPLESS. To join NAHU, visit nabip.org/membership.