Geisinger CMS Disclaimer Stickers

There has been some confusion over the CMS disclaimer requirement set in the 2023 final rule. Geisinger hopes to clarify that and supply you with the guidance where this subject is addressed.

CMS is asking that all TMOs disclose ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or1–800–MEDICARE to get information on all of your options.’’

This is required for calls by TMOs but also on marketing materials. You are welcome to use your own generic disclaimer for your materials, however we are able to provide labels for you if you do not have your own and would like to use these. This is available immediately via pdf for self-printing  or you can get actual stickers from Geisinger by emailing the broker care team (brokerhelp@thehealthplan.com) and requesting a supply. They will then mail to you.

Page 27822 of the final rule speaks to the disclaimer requirement:

“Second, we proposed to codify, in §§ 422.2267(e)(41) and423.2267(e)(41), the requirement that TPMOs use a standardized disclaimer that states ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contactMedicare.gov or 1–800–MEDICARE to get information on all of your options.’’ As part of this proposal, MA organizations and Part D sponsors would need to ensure that any TPMO with which they do business, either directly or indirectly, utilizes this disclaimer where appropriate. MA organizations and Part D sponsors would also need to ensure TPMO’s adherence with these requirements through contractual arrangements, review of materials or other appropriate oversight methods available to the MA organization or Part D sponsor such as complaint reviews or audits. CMS would not require the disclaimer for those TPMOs who truly offer every option in a given service area. TPMOs would be required to prominently display the disclaimer on their website and marketing materials, including all print materials and television advertising that meet the definition of marketing. We also would require that the disclaimer be provided verbally, electronically, or in writing, depending on how the TPMO is interacting with the beneficiary. In cases where the TPMO is providing information through telephonic means, the TPMO would be required to provide this disclaimer within the first minute of the call. We believe the proposed disclaimer would help to reduce the type of beneficiary confusion CMS observed when we listened to TPMO-based sales calls.”

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