Medicare Advantage Rules to tighten for Independent Agents this Fall says Cavulus CEO.
PITTSBURGH, July 18, 2022 /PRNewswire/ -- Beginning this fall Patrick Phillips, CEO of Cavulus, a leading technology provider in the Medicare Advantage (MA) industry, says new rules from the Centers for Medicare & Medicaid Services (CMS) will require independent agents who sell Medicare Advantage plans to record all phone calls with beneficiaries.
Phillips believes this step is in response to a barrage of TV commercials pitching MA plans via third party marketing organizations (TPMOs). The ads commonly feature celebrity spokespeople and have garnered complaints that CMS describes as "confusing and misleading' – often leading to improper enrollments.
While TPMOs likely prompted action from CMS, Phillips notes that the regulations currently apply to the entirety of the MA broker community.
"These new requirements will burden smaller agencies and independent agents," Phillips explains. "The recording technology is the simplest part; ten-year storage, indexing, archiving, and data transfer protocols for future CMS and MA plan audits will be complicated without IT resources."
"It's complexity that we're familiar with since we've been solving it for Medicare Advantage organizations (MAOs) since 2006," says Phillips. "Internal call centers, direct sales and support staff have long been required to operate on recorded lines."
"MAOs of all sizes utilize our solutions to drive compliant growth through our embedded compliance features like dynamic CMS-approved call scripts. Our technology creates a uniformity of messaging and simplicity in the face of an audit by capturing a complete picture from marketing to enrollment."
Phillips envisions TPMOs, large agencies, and MAOs offering their technology to independent agents as a perk, which may be a quick fix.
"Cavulus clients extend our solutions to their third-party call centers for a consistent member experience and to maintain control of the data. This may be an option with other solutions if the proper security, privacy, and data-sandboxing protocols are in place."
Phillips emphasizes that MAOs are responsible for compliance. "They must be concerned about what systems third parties use to store sensitive data with HIPAA, PHI, and CMS guidelines in mind," he says.
ABOUT CAVULUS - Cavulus is a technology driven specialist in Medicare Advantage insurance solutions. The Cavulus Cloud-based MA Platform (Cavulus MAP™) unifies marketing, sales and enrollment operations, and is utilized by many top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins, Lumeris and United Healthcare. For details: www.cavulus.com.
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SOURCE Cavulus
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