New CMS guidance shows how long to store Medicare calls and how to organize them, among other questions

As AEP fast approaches, CMS provides more details on the Medicare marketing final rule. This rule –applicable to third party marketing organizations which includes agents and brokers – could significantly change agent procedures in order to maintain compliance.

First, what should be done if a beneficiary does not want to be recorded? Some fear beneficiaries might shy away from calls after hearing the required disclaimer. Quite simply, the call must end. CMS has also states that if a beneficiary is enrolled in a health plan or discussing any preliminary pre-enrollment information, that call recording must be saved and stored.

But what about HIPAA? All HIPAA regulations and privacy standards still apply, with the responsibility to comply falling on the agent or broker. More information regarding agent liability will be released through the body handling any potential security breaches, the HHS Office for Civil Rights.

Next, more details behind call storage. CMS states that for the 10 years of required storage, calls can be organized by beneficiary instead of date and time. No matter the chosen organization process, agents and brokers are expected to be able to provide CMS with recordings on demand for review. Reasons for this might include complaints or audits, but also could happen at random.

CMS does not provide any further guidance for agents or brokers and directs any other inquiries to CY2021 MA Enrollment and Disenrollment Guidance 40.1.3.

CMS plans to initiate compliance action plans with any who fail to comply. Individual states will determine if an infraction is worthy of revoking a license.