Notice: Do not rely only on Agility’s key points and summaries to educate your organization on regulations and new requirements. Please review State and Federal regulation and guidance to gain a full understanding of each requirement and the changes that your organization may need to make.
Effective July 1,2023
ANY MATERIAL or ACTIVITY that is distributed via ANY means that mentions ANY BENEFIT(vision, hearing, reduced premium….) will be considered marketing and must be submitted to HPMS. Even when a Carrier is not mentioned on or in the marketing.
Effective 06/05/2023
The TPMO disclaimer must add SHIPs as an option for beneficiaries to obtain additional help; modifying the TPMO disclaimer to state the number of organizations represented by the TPMO as well as the number of plans.
Example of new standard
“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.”
Effective 09/30/2023 for all activity related to CY 2024
Requirement of 48 hours between a Scope of Appointment and an agent meeting with a beneficiary.
NOTE EXCEPTIONS:
*Beneficiaries who call or walk into an agent’s office, a kiosk, a plan’s office or any other walk in will not be subject to the 48-hour rule.
*Beneficiaries who are approaching the end of a valid enrollment period. This could be the end of the AEP, the OEP, an SEP or the ICEP.
Effective 09/30/2023 for all activity related to CY2024
SOA and BRC are now valid for 12 months from the date the individual completes and dates the form.
The CMS Medicare Learning Network (MLN) is a direct resources of Publications, News and Trainings. The training link here is a great refresher and or introduction to Medicare to help you and your staff get comfortable with the different options of Medicare available to beneficiaries.
CMS Medicare Learning Network provides a prepackage Fraud Wate and Abuse course with certification. A great tool to use and demonstrate a key component of education and compliance within your organization.
