Medicare Advantage Managers Propose 2024 Ban on Lead Sales

What You Need to Know

The current draft would not allow any sales of Medicare Advantage or Medicare drug plan prospect leads.
Insurers might have to listen in on some agent calls with consumers and set up mystery shopper programs.
Users would have to be able to search a plan provider directory using any required type of data, such as a telephone number or address.

The Centers for Medicare and Medicaid Services could ban use of independent lead-generation services in the Medicare Advantage plan and Medicare Part D prescription drug plan markets in 2024.

CMS could also require the plan issuers to set up agent call monitoring and mystery shopper programs; require both issuers and “third-party marketing organizations,” or TPMOs, to submit marketing materials for CMS review; and require agents to review topics such as a customer’s need for specialist care and wheelchairs during sales calls.

CMS has put those proposals in a draft version of a “parameters” document it will use to set Medicare plan program rules for 2024. The draft is on track to appear in the Federal Register, an official government regulatory publication, on Dec. 27.

Comments are due on the proposals by Feb. 13, 2023.

What It Means

If you sell Medicare plans, you might have to change the way you get leads and handle sales calls in 2024.

If you are a retirement planner outside the Medicare plan market, you might find that clients are more likely to get extensive advice when they sign up for Medicare coverage, but you also might find that, because of the effects of the new requirements on the supply of Medicare agents, some clients will have a difficult time connecting with agents.

The Background

Consumers, consumer advocacy groups, traditional retail insurance agents and members of Congress have been complaining for the past few years about aggressive Medicare plan ads on television and about plan marketing websites that look, in some cases, as if they are official Medicare plan enrollment websites.

CMS regulates the sales of Medicare Advantage plans and Medicare drug plans, but not Medicare supplement insurance policies.

The agency previously defined a class of Medicare TPMOs; required TPMOs to add disclaimers about the limitations of their plan menus; and required TPMOs to record calls with clients and prospects.

Agent & Broker Sales Leads

Today, national and regional companies often use television ads and Medicare information websites to develop leads for sales agents and brokers.

CMS officials say in the preamble, or official introduction, to the proposed regulations that consumers often think that they are requesting information from one organization and do not understand that the organization could sell the contact information to other parties.