MAJOR CHANGE: Understanding the 2024 CMS Final Rule’s New 48-Hour Scope of Appointment (SOA) Rules

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So it is rare that another blog compares to TCPAWorld.com when it comes to quality and comprehensive content, but Drips.com just did a FANTASTIC piece on the CMS final rule. And I love it.

Here is a snippet:

Understanding The New SOA 48-Hour Rule With Puja J. Amin

As we discussed previously, the 2024 CMS Final Rule included a major change to Scope of Appointment (SOA) rules. As Medicare organizations know, the Scope of Appointment is a form that beneficiaries must sign to outline the topics that are allowed to be discussed during a scheduled meeting. This helps ensure that the beneficiary stays in control, helps them make informed decisions about their benefits, and can prevent misleading marketing tactics.

The SOA changes could mean huge changes for how Medicare organizations handle outreach about their plans. So, Drips sat down with our legal counsel and outreach compliance expert Puja J. Amin from Troutman Amin, LLP. In this conversation, Puja shares key insights into the important aspects of the new rule and how companies can adapt to the change.

But first, let’s go over the details of the new 48-hour rule for Medicare Scope of Appointment forms.

How The 2024 CMS Final Rule Changes SOA

With the 2024 CMS Final Rule, there must be a 48-hour waiting period between the signing of the SOA form and the meeting or call with the beneficiary. As we already mentioned, this gives the beneficiary time to make informed choices and consult with family or trusted third parties about their coverage options.

When The 48-Hour Rule Applies

The 48-hour rule applies to all SOA forms starting September 30, 2023. It is required any time an insurance agent or broker wants to meet with a current or prospective Medicare health plan beneficiary to discuss plans and benefits.

There are two exceptions to this rule. The first exception is during the last four days of an election period, when you can obtain a same-day scope of appointment. The second exception is for “walk-in” meetings initiated by the beneficiary.

 


Quote from Puja J. Amin about the SOA 48-hour rule. "You have to tread very carefully here. You have to understand why this rule was implemented."
 

How The 48-Hour Rule Challenges The Medicare Industry

While the effects of the 48-hour rule are still unfolding, it’s already clear that it could pose challenges for Medicare outreach. In particular, the 48-hour waiting period is sure to result in some potential beneficiaries failing to follow up and complete enrollment.

Read more RIGHT NOW at: https://drips.com/blog/understanding-the-new-soa-48-hour-rule-with-puja-j-amin

And be sure to subscribe to Deserve to Win the Magazine for more great information like this!

 

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Published by Eric "Czar" Troutman

The Czar of TCPAWorld Eric Troutman is one of the country’s prominent class action defense lawyers and is nationally recognized in Telephone Consumer Protection Act (TCPA) litigation and compliance. He has served as lead defense counsel in more than 70 national TCPA class actions and has litigated nearly a thousand individual TCPA cases in his role as national strategic litigation counsel for major banks and finance companies. He also helps industry participants build TCPA-compliant processes, policies, and systems. Eric has built a national litigation practice based upon deep experience, rigorous analysis and extraordinary responsiveness. Eric and his team feel equally at home litigating multibillion dollar telecommunications class actions in federal court as they do developing and executing national litigation strategies for institutions facing an onslaught of individual TCPA matters. They thrive in each of these roles – delivering consistently excellent results – while never losing sight of the client experience. While many firms now tout TCPA expertise, Eric has been there from the beginning. He built one of the country’s first TCPA-only defense teams and began serving as national TCPA counsel for his clients nearly a decade ago. This perspective allows him to swiftly develop the right litigation strategies for dealing with recurring problems, without wasting time on tactics that are bound to fail. Eric’s rich historical perspective and encyclopedic knowledge of the TCPA landscape also make him an invaluable resource to institutional compliance teams struggling to comply with the shifting regulatory landscape. No task is too small – or too big. Indeed, Eric and his team have helped build TCPA-compliant systems and processes for some of the largest and most complex corporate entities in the country. He commonly works with in-house compliance counsel to build and implement enterprise and business-line specific TCPA solutions, performs TCPA audits and drafts and reviews proposed TCPA policies and procedures. He and his team also have the technical expertise necessary to assist call centers seeking to develop TCPA-resistant call path architecture or to modify existing telephony and software integration to better insulate from potential TCPA exposure. Eric has built a reputation for thought leadership. An avid blogger and speaker, he has been at the forefront of the industry’s effort to push for clarity and a return to sanity for the TCPA for years. He was selected to advocate for the financial services industry on important TCPA issues before the Federal Communications Commission and co-authored the nation’s only comprehensive practice guide on TCPA defense. In his spare time, Eric leads defense teams representing banks and other financial services companies in consumer finance litigation matters. He has experience representing clients in UCC, TILA, RESPA FCRA, CCRA, CLRA, FDCPA, RFDCPA and FCCPA claims, as well as in fraud and bank operations issues.

2 Comments

  1. How does this help medicare beneficiaries if they have to wait 48hrs before the plan presentation. Shouldnt it be that they cannot enroll until 48hrs after they are presented a plan?

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  2. This new rule is just making it difficult for beneficiaries to get help with Medicare plans. If a beneficiary calls me and wants to meet with me tomorrow, am I supposed to say “sorry Mr/Mrs beneficiary, but I can’t meet with you tomorrow, even if that’s the only time you have this week, because you have to sign a form 48 hours in advance ..” It doesn’t make sense because we aren’t allowed to initiate unsolicited contact with beneficiaries anyway, so if they are calling us, why do we have to make more hoops for beneficiaries to jump through just to get some help? Yes, yes…agents aren’t the only source of help (as the now required disclaimer we have to recite every time we talk to a beneficiary states) but many beneficiaries aren’t willing to sit on hold or go through the whole “press 1 for this, press 2 for that..enter your medicare number…that number is incorrect..please re-enter your number…” etc. They would rather just go to an agent they can see face-to-face or talk with on the phone without the hassle and impersonal nature of a 1-800 number. It’s almost like they want to do away with agents so they are making it harder and harder for us. I understand wanting to protect beneficiaries, but this has gone way overboard to the point of making things way more difficult than they need to be.

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