Compliance Knowledge Center

Medicare AI Compliance Resources

Source-driven guides to the regulatory framework governing AI-assisted Medicare programs — for brokers, carriers, compliance teams, and TPMOs.

We cite primary sources, separate legal requirements from industry practice, and acknowledge uncertainty where regulations are unsettled. Not legal advice.

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The comprehensive guide covers all major regimes in one place.

Medicare AI Compliance Guide: HIPAA, TCPA, TPMO & Consumer Health Privacy

Seven sections covering every regulatory regime that governs AI-assisted Medicare lead generation — with executive answer blocks, 20 FAQs, and 8 primary-source citations. The canonical reference for all other content on this hub.

Sections: 7 FAQs: 20 Sources: 25 primary Published: June 2026

Topic Guides

Deep dives by regulation

Each topic guide focuses on one regulatory regime — with a practical focus for Medicare programs.

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HIPAA & Medicare Lead Generation

When HIPAA actually applies to Medicare programs, the Covered Entity / Business Associate analysis, and what a BAA does and doesn't cover.

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TCPA & Medicare Text Messaging

Prior express written consent requirements, the 2024 one-to-one consent rule, opt-out obligations, and why TCPA is often the higher-velocity litigation risk.

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Washington My Health My Data Act

Opt-in consent requirements, the private right of action, extraterritorial reach, and what it means for nationally-marketed Medicare programs.

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CMS Medicare Marketing & TPMO Rules

TPMO classification, required disclaimers, 10-year recording retention, Scope of Appointment requirements, and the technology vendor analysis.

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State Consumer Health Privacy Laws

Washington MHMDA, Nevada SB 370, CCPA/CPRA sensitive data, and an overview of other state frameworks — compared and mapped to Medicare programs.

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Need Full HIPAA? How We Handle It

Message channel options (managed by Side Nerd or your org), HIPAA-eligible infrastructure, AI model handling, and vendor BAA chain — plus a full compliance package available on request.

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White Paper

For carriers, insurers & compliance teams

The full compliance and regulatory framework document — structured for CISOs, procurement, and legal review.

Compliance & Regulatory Framework for AI-Assisted Medicare Communication

Four-section analysis covering HIPAA scope and the covered-entity path, state consumer-health privacy laws (WA, NV, CA, CO), TCPA consent requirements and the 2024 one-to-one rule, and CMS Medicare marketing requirements for TPMOs. Includes a responsibility allocation summary and 24 primary-source citations. Intended for CISOs, compliance officers, and carrier procurement teams.

Sections: 4 Sources: 24 primary Audience: CISOs, compliance teams, carriers Published: June 2026

Editorial Principles

1
Cite primary sources — statutes, regulations, and agency guidance — wherever possible.
2
Separate legal requirements from industry best practice. Label each clearly.
3
Distinguish HIPAA from non-HIPAA privacy laws. Most compliance conversations conflate them.
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Acknowledge uncertainty when regulations are evolving or agency guidance is absent.
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Encourage corrections and discussion. Compliance is a collective knowledge problem.
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Prioritize accuracy over marketing language. Never claim legal certainty where regulators haven't provided it.
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Verify and update sources quarterly. Note the last-verified date on every citation.
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Nothing on this hub is legal advice. Consult qualified counsel for program-specific determinations.