Compliance Corner: CMS Consumer Consent Requirements
The Centers for Medicare & Medicaid Services (CMS) recently published a detailed FAQ document that clarifies consent requirements that must be followed by brokers and agents selling Affordable Care Act (ACA) plans, such as UnitedHealthcare Individual & Family Plans (IFP). Please make sure that you and others in your organization are familiar with the full contents of this FAQ document.
According to CMS, agents and brokers must obtain and document consent from consumers prior to assisting with or facilitating enrollment in an ACA plan. Although CMS does not provide specific direction on how the consent should be documented, brokers and agents are responsible for documenting and retaining that consent – whether it is in the form of signed paper or electronic documents, email or recorded verbal consents. Consumers may revoke this consent at any time. Furthermore, consumers may choose to work with another agent or broker without rescinding their original consent, so if you notice changes on a consumer’s eligibility application that were not made by you, do not adjust the application. You must check with the consumer first, to see if the changes were authorized.
It is important to note that consumer consent must be obtained every time an action is taken to change or update a consumer’s eligibility application or plan selection. Agents, brokers and web-brokers must never change a consumer’s eligibility application information or plan selection without documenting that the consumer consented to the change.
For more information about CMS consent requirements, click the button below.
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