Medicare Agent Compliance Rules: Scope of Appointment, the TPMO Disclaimer and Call Recordings
Compliance isn't the fun part of this business, but it's the part that keeps you in it. Here are three rules every Medicare agent should know cold under the current CMS rules. Check the current regulations each year, because CMS updates them.
1. Scope of Appointment: still required, no 48-hour wait
You still need a documented Scope of Appointment before a personal marketing appointment. Per the current federal rules (42 CFR 422.2274 and 422.2264), the old 48-hour waiting period is gone, per the CMS CY 2027 final rule.
No wait doesn't mean no SOA. Get it, document it, and stay inside what the client agreed to discuss.
2. The TPMO disclaimer
If you don't sell for every MA organization in the area, the third-party marketing organization disclaimer under 42 CFR 422.2267(e)(41) applies. It begins, "We do not offer every plan available in your area," and states how many organizations you represent. Give it before you talk benefits, and use the standardized wording.
3. Record and keep calls for 6 years
Per 42 CFR 422.2274, marketing, sales and enrollment calls, including the audio of web-based calls, must be recorded and kept in their entirety for at least 6 years. Know where your recordings live and make sure you can pull one when asked.
Build it into your process
Put the SOA step in your booking flow so it never gets skipped.
Script the TPMO disclaimer at the top of every call.
Check your recording setup and storage before your busy season, not during it.
Review the rules every year when CMS publishes changes.
For more, see our guides to Medicare lead generation and compliance and carrier appointments and certification.
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FAQ
Do Medicare agents still need a Scope of Appointment?
Yes. A documented SOA is required before a personal marketing appointment. The old 48-hour waiting period was removed.
What is the TPMO disclaimer?
It's standardized language required under 42 CFR 422.2267(e)(41) for third-party marketing organizations that don't sell every MA plan in the area. It starts, "We do not offer every plan available in your area."
How long must Medicare sales calls be kept?
At least 6 years, in their entirety, per 42 CFR 422.2274.
