What Insurance Agencies Need to Know About the New CMS Ruling: Recording All Phone Calls

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At this point, you’ve probably already heard of the news from the Centers for Medicare & Medicaid Services (CMS) that impacts healthcare professionals and the healthcare industry at large. The CMS Final Rule 2023 was announced in May of 2022 and includes some changes that will soon need implementation. This new rule is set to go into effect on October 1, 2022, and will require all Medicare and Medicaid marketing calls to be recorded and stored.

It is believed that this new ruling from CMS is in response to commercial ads utilizing celebrities that are misleading at best and have caused some backlash. The rule essentially applies to all agents, whether field agents or others and requires them to record all phone calls. What does it mean exactly? We’re giving you all of the details you need to know. 

An Overview of the CMS Ruling

In May of 2022, CMS published a final ruling announcing policy and regulatory revisions for Contract Year 2023, which go into effect October 1, 2022. One big takeaway from this ruling is that health care provider field agents must record all calls with beneficiaries, including the enrollment process. The barrage of deceiving TV commercials that have been airing recently is believed to be the catalyst for this decision. 

What This Means for Insurance Agencies

Some things will need to change before October to ensure agents meet these new requirements come 2023. 

For all conversations, the following requirements must be included on the scope of the appointment form or on the recorded call itself: 

  • Product types to be discussed
  • Date of appointment
  • Beneficiary and agent contact information

A statement disclosed that there is no obligation to enroll current or future Medicare participants, and their status will not be impacted. Automatic enrollment also will not occur. However, a new SOA is required if the beneficiary requests information regarding a different plan type than agreed upon previously.

Additionally, the disclaimer “I/We do not offer every plan available in your area. Please contact medicare.gov or 1-800-MEDICARE to get information on all your options” must be conveyed as follows:

  1. Verbally expressed within the first minute of a sales phone call
  2. Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means
  3. Prominently displayed on any and all third-party marketing organization websites
  4. Any third-party marketing organization marketing materials, including print materials and television advertisements

What is Required Under the Ruling?

The recording requirement applies to all agents health care professionals who enroll beneficiaries into new plans, whether they are current or new clients. The wording of the rule references “marketing” calls, but NAHU confirmed that CMS interprets “enrollment” as “marketing.” You can assume enrollment and marketing are one and the same in any of the ruling’s language.

This means that online applications that agents walk through with their clients are also subject to recording. However, this health insurance market reform will not affect SHIPS. 

There does not appear to be an audit plan to verify compliance, but this could change as more details come to light. 

What does this mean for Insurance Agents that are using Intulse?

If you’re an Intulse client, we have good news! Meeting this requirement is relatively easy. Call recording is a feature you already have access to and doesn’t cost you anything to enable, even on your mobile devices. You may incur call recording storage fees, but they are very affordable.

You can choose to start/stop recording any call you’re actively on from the My Phone screen in the Intulse Mobile App. Or, you can contact our support team to have automatic call recording turned on for all incoming and/or outgoing calls.

VoIP CRM integrations for insurance agencies with Intulse

If you’re not a current Intulse client but need assistance with call recordings to ensure you’re following requirements in the new year, we are here to help. We don’t just care about CRM phone systems for insurance agents. We want to help you! 

Contact our team today to learn more

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