Highmark Third Party Marketing Organization Call Recording Requirements - UPDATED

Third Party Marketing Organization Call Recording Requirements Relevant to Individual Agents

On May 9, 2022 CMS published a final ruling announcing policy and regulatory revisions for Contract Year 2023. Among the changes are requirements for disclaimers and call recording. Required implementation of these measures begins October 1, 2022.

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The Standard Disclaimer

When speaking with a prospective enrollee, third-party marketing organizations (TPMOs) MUST USE the following standardized disclaimer: “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 or 1-800-MEDICARE to get information on all of your options.”

• This disclaimer must be provided verbally, electronically, or in writing. When communicating via phone this must be disclosed within the first minute of the call.
• This disclaimer must also be disclosed in face to face meetings.

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Call Recording Requirements

TPMOs must record all sales calls in their entirety. Sales calls may include, but are not limited to, appointment setting, preliminary plan reviews, and enrollments.

• In Pennsylvania and Delaware, all involved parties must consent to call recording to continue the call.
• ̶ ̶I̶n̶ ̶W̶e̶s̶t̶ ̶V̶i̶r̶g̶i̶n̶i̶a̶ ̶a̶n̶d̶ ̶N̶e̶w̶ ̶Y̶o̶r̶k̶,̶ ̶o̶n̶l̶y̶ ̶o̶n̶e̶ ̶p̶a̶r̶t̶y̶ ̶m̶u̶s̶t̶ ̶c̶o̶n̶s̶e̶n̶t̶ ̶t̶o̶ ̶c̶a̶l̶l̶ ̶r̶e̶c̶o̶r̶d̶i̶n̶g̶ ̶t̶o̶ ̶c̶o̶n̶t̶i̶n̶u̶e̶ ̶t̶h̶e̶ ̶c̶a̶l̶l̶. (See further update below)
• Call recordings must be retained in a HIPAA compliant manner for 10 years.

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For a more detailed overview of these requirements, click here.

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Update - October 24, 2022

Highmark would like to share some additional guidance that has recently come to their attention, regarding face to face virtual interactions and what to do if a prospect or member does not want to be recorded. Please be aware:

• Face to face virtual interactions on platforms like Zoom MUST be recorded.
• If the prospect or member does not want to be recorded, you should stop the recording and you MUST END the call