CMS Final Rule for 2024
Revised Jan 9, 2024
The CMS Final Rule for 2024 includes several updates that will impact your marketing and communication efforts. We’ve highlighted some of the key changes below.
Please note that the following applies to all 2024 marketing and communications beginning September 30, 2023.
- The Third Party Marketing Organization (TPMO) disclaimer has been modified to add State Health Insurance Programs (SHIPs) as an option for beneficiaries to obtain additional help.
- The TPMO disclaimer must also state the number of organizations represented by the TPMO, as well as the number of plans.
- If the TPMO sells for all MA organizations and/or Part D sponsors in the service area, the disclaimer consists of the statement: “Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.”
- If a TPMO does not sell for all MA organizations and/or Part D sponsors in the service area, the disclaimer consists of the statement: “We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”
Scope of Appointments
- Scope of Appointments (SOAs) and Business Reply Cards (BRCs) will only be valid for 12 months from the beneficiary’s signature date or the beneficiary’s request for more information. If the beneficiary wants to be contacted past the 12-month period, you must secure and document that permission through a new SOA, BRC, or similar mechanism.
- If someone walks into your office or calls you, the following does not apply. However, if you are scheduling an appointment, CMS now requires the SOA to be collected 48 hours in advance—except for SOAs that are completed during the last four days of a valid election period for the beneficiary.
- Educational events and marketing events must be spaced more than 12 hours apart if they are being held at the same location (meaning the same or adjacent buildings).
- In addition, SOA cards cannot be collected at educational events.
Additional details—as well as information on other changes that may impact brokers—can be found in the CMS Final Rule Fact Sheet.