Yesterday, NAHU CEO
Janet Trautwein testified in front of the National Association of Insurance Commissioners
during NAIC’s Summer Meeting. In her testimony, Trautwein discussed the recent
Medicare marketing final rule issued in May.
The final rule
attempts to “protect Medicare beneficiaries by ensuring they receive accurate
and accessible information about Medicare coverage.” To do this, the rule
strengthens oversight of third-party marketing organizations (TPMOs) to “detect
and prevent the use of confusing or potentially misleading activities to enroll
beneficiaries.” One way CMS is looking to increase this oversight is by
requiring that any telephonic “marketing” calls with beneficiaries or potential
beneficiaries be recorded. While the intention of this rule is to stop
fraudulent or misleading actors – such as certain call centers – from
manipulating Medicare beneficiaries, the rule’s overly broad definition of a
TPMO includes licensed agents and brokers.
dissatisfaction is not generally with their agent of record; it is with call
centers that solicit beneficiaries to switch plans that do not necessarily meet
their needs. Including licensed agents and brokers in the definition of TPMO
needlessly subjugates responsible actors to difficult and burdensome telephonic
this issue to the NAIC’s attention, highlighting the potential damage that this
regulation could cause if it is implemented as written. These new regulations
will likely discourage many licensed and certified agents and brokers from
representing Medicare Advantage and prescription drug plans, leaving millions
of Medicare beneficiaries without access to professional assistance in their
The cost of setting
up a HIPAA-compliant audio recording system with adequate and protected storage
capabilities far exceeds the abilities of many of these licensed and certified
agents who are now facing a decision as to whether to participate in this
fall’s Annual Enrollment Period. An estimated 100,000 licensed and certified
independent agents and brokers certify each year to offer Medicare Part C and D
plans; without these licensed and certified agents assisting in enrollments,
Medicare beneficiaries will have few choices in finding accurate enrollment
assistance and will be led directly to the bad actors that this rule seeks to
protect them from.
The NAIC is
currently reviewing a model state regulation to address improper marketing of
insurance plans and unscrupulous actors in the health insurance market.
Trautwein’s testimony will help to shape the language of the model rule and
NAHU will be providing written comments to the NAIC to advocate on behalf of
the role agents and brokers play in the health insurance market.