CMS Marketing Rules

CMS Medicare Marketing & TPMO Compliance: The Complete Operator Guide

TPMO classification, required disclaimers, 10-year recording retention, Scope of Appointment rules, and when a technology platform crosses the TPMO line — sourced to 42 CFR §§ 422.2268 and 423.2268.

MediMatch Compliance Hub · Updated June 2026 · Primary sources cited

What Is a TPMO?

Executive Answer

A Third Party Marketing Organization (TPMO) is any entity that markets, sells, or facilitates enrollment in Medicare Advantage (MA) or Part D plans under a written arrangement with a plan sponsor. The definition is broad: FMOs, independent broker agencies, lead aggregators, and technology platforms that present plan options to beneficiaries all qualify. If your platform touches the enrollment funnel, assume TPMO status applies until you have a documented analysis showing otherwise.

CMS defines TPMOs in 42 CFR §§ 422.2268(b) and 423.2268(b) as entities that, pursuant to a written arrangement with one or more MA organizations or Part D sponsors, conduct marketing or sales functions on behalf of those plans. The definition sweeps broadly — it is not limited to entities that directly employ licensed agents.

The TPMO framework was substantially strengthened in the 2023 and 2024 CMS Final Rules, following CMS enforcement findings that beneficiaries were being misled about plan availability and that marketing calls were not being recorded consistently. The current rule treats any organization in the distribution chain — including technology intermediaries — as a TPMO if their activities meet the definition.

Who qualifies as a TPMO?

  • Field Marketing Organizations (FMOs) and Independent Marketing Organizations (IMOs)
  • Lead generation companies that pass data to licensed agents for plan enrollment
  • Digital platforms that present MA or Part D plan options and collect beneficiary information
  • Call centers operating on behalf of plan sponsors under contract
  • Technology vendors whose platform materially assists in sales presentations to beneficiaries

Who is not a TPMO?

  • Individual licensed agents and brokers (they are subject to agent/broker rules, not TPMO rules)
  • Pure administrative vendors with no beneficiary-facing sales function
  • Technology vendors whose sole function is operational (e.g., CRM, billing) and who do not present plan options

The 4 Core TPMO Compliance Requirements

Executive Answer

CMS imposes four concrete obligations on TPMOs: (1) delivery of a verbatim disclaimer before presenting plan information, (2) recording of all marketing and sales interactions with 10-year retention, (3) completion of a Scope of Appointment before discussing plan options, and (4) disclosure of compensation arrangements to beneficiaries on request. Failure on any of these can result in civil monetary penalties of up to $100,000 per violation per beneficiary.

  • TPMO disclaimer — Verbatim disclosure that the TPMO does not represent all plans must be delivered before any plan-specific information is shared.
  • Recording + 10-year retention — All marketing calls, sales calls, and enrollment calls must be recorded and retained for 10 years.
  • Scope of Appointment — Documentation of which product types the beneficiary agreed to discuss, obtained before the sales appointment.
  • Compensation disclosure — Disclosure of whether the TPMO receives compensation and the nature of that compensation, upon beneficiary request.

CMS made these requirements binding in the 2023 Final Rule (88 FR 22120, April 5, 2023) and further clarified scope in the 2024 Final Rule (89 FR 30448). Plan sponsors bear downstream liability for TPMO non-compliance under their contracts with CMS.

The Required TPMO Disclaimer

Executive Answer

CMS mandates a specific verbatim disclaimer. It cannot be paraphrased. It must appear before plan-specific information is presented — not at the end, not buried in fine print. For digital and SMS channels, it must be displayed prominently. Many TPMO enforcement actions trace back to this requirement being skipped or delivered too late in the interaction flow.

Required CMS TPMO Disclaimer — Verbatim Text
"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."
Source: CMS Medicare Marketing Guidelines, Chapter 3 (current annual version); 42 CFR §§ 422.2268, 423.2268

Timing and placement requirements

The disclaimer must be delivered before plan-specific information is presented. For phone calls, this means at the beginning of the call. For digital flows including SMS and web, it must appear before the beneficiary is shown any plan options, premium information, or coverage comparisons.

Does it apply to SMS?

Yes. CMS confirmed in Chapter 3 of the Medicare Marketing Guidelines that the disclaimer requirement applies to all marketing communications regardless of channel. For SMS-based Medicare outreach programs, the disclaimer must be transmitted as part of the opening exchange — before the system or agent presents any plan options or asks beneficiary questions that are part of the enrollment qualification flow.

Non-English communications

If marketing materials are provided in languages other than English, the disclaimer must also be provided in the same language. CMS does not permit English-only disclaimers in communications sent to beneficiaries who have indicated a preference for another language.

Recording and Retention Requirements

Executive Answer

Every marketing call, sales call, and enrollment call must be recorded. Retention period is 10 years. This is not a best practice — it is a CMS mandate under 42 CFR §§ 422.2268 and 423.2268. "Call" is interpreted broadly by CMS to include video conferences, recorded voicemails used in outreach, and any communication channel used for sales presentations. Organizations that route calls through third-party platforms must ensure those platforms contractually commit to the same retention schedule.

What must be recorded

  • All phone calls in which plan options are discussed or enrollment is processed
  • Video sales presentations, including those conducted via telehealth platforms
  • Any audio component of a digital enrollment flow that includes a live agent
  • Scripted or pre-recorded outreach calls that include plan-specific information

What the 10-year clock covers

The 10-year retention period begins at the date of the recording, not the date of enrollment. CMS may audit recordings in connection with beneficiary complaints, state insurance department investigations, or routine plan oversight audits. Recordings must be accessible and retrievable — not just archived.

Vendor accountability

If a TPMO uses a third-party telephony or recording platform, the TPMO remains responsible for compliance. Vendor agreements should specify the 10-year retention obligation, data portability in the event the vendor relationship ends, and chain-of-custody documentation sufficient for CMS audit response.

Channel Recording Required Notes
Inbound phone call Required Applies whether call is answered by live agent or interactive system
Outbound sales call Required Includes callback calls initiated after online lead submission
Video appointment Required Beneficiary must consent to recording; withholding consent triggers agent-only meeting
SMS / text exchange Retain logs CMS requires retention of written communications; recording concept applied as complete message logs
Email Retain Marketing emails involving plan information must be retained in the same 10-year window

Scope of Appointment Requirements

Executive Answer

A Scope of Appointment (SOA) documents what product types — MA, PDP, Medicare Supplement, etc. — the beneficiary agreed to discuss before a sales appointment. Under 42 CFR § 422.2264, the SOA must generally be obtained at least 48 hours before the appointment. The 48-hour window is waived when the beneficiary initiates contact within that window, but the SOA must still be completed before plan options are discussed. SOAs must be retained for 10 years alongside enrollment records.

The 48-hour rule and its exceptions

The standard requirement is that the SOA be obtained at least 48 hours before any sales appointment. This prevents "scope creep" — where an agent scheduled to discuss one product uses the meeting to sell another. Two exceptions apply:

  • Beneficiary-initiated contact: If the beneficiary contacts the TPMO or agent within 48 hours of the appointment (e.g., calls a hotline or submits an online lead), the 48-hour advance requirement is waived. The SOA must still be completed before plan discussion begins.
  • Walk-in or uninstructed contact: Beneficiaries who appear at a sales event without a prior appointment may complete the SOA on-site, immediately before the appointment.

SOA format and e-signature

CMS allows electronic SOA completion and accepts e-signatures under the Electronic Signatures in Global and National Commerce (E-SIGN) Act. Digital-first programs may capture SOA via web form, SMS reply, or IVR confirmation — provided the system creates a durable, timestamped record. The SOA record must identify the beneficiary, the date, and the specific product categories authorized for discussion.

What happens if you discuss an out-of-scope product

Discussing a plan type not covered by the SOA is a marketing violation. The agent must obtain a new SOA before discussing the additional product type. CMS has cited this as a significant compliance failure in recent audits — particularly when agents transition from Medicare Supplement presentations to MA plan discussions without a separate SOA.

Technology Vendors: When Does Your Platform Become a TPMO?

Executive Answer

CMS's test is functional, not structural: if a platform presents MA or Part D plan options to beneficiaries, collects beneficiary information for enrollment purposes, or materially assists in a sales transaction — regardless of whether licensed agents are nominally involved downstream — that platform is likely operating as a TPMO. The key risk factor is whether the platform's interaction with the beneficiary constitutes a "sales presentation." Intake-only platforms that collect eligibility information without presenting specific plans occupy a grayer area; those that show plan comparisons or premiums do not.

The functional test

CMS has clarified through guidance and enforcement that TPMO status depends on what a platform does, not how it is structured legally. The following activities push a technology platform toward TPMO classification:

  • Displaying MA or Part D plan options, premiums, or coverage details to beneficiaries
  • Scoring or ranking plans for a beneficiary based on their inputs
  • Facilitating or processing enrollment applications
  • Presenting information that is part of the enrollment qualification process and tied to a specific plan sponsor
  • Operating under a written arrangement with an MA organization or Part D sponsor

Activities that do not trigger TPMO status

  • Pure Medicare eligibility verification (Part A/B confirmation, effective date lookup) without plan presentation
  • Administrative CRM functions that route leads to licensed agents without making plan presentations
  • Educational content about Medicare generally, without promotion of specific plans

How MediMatch approaches this line

MediMatch's intake function qualifies employees for Medicare eligibility and routes them to licensed broker agents — it does not present specific MA or Part D plan options directly to beneficiaries. This keeps MediMatch on the intake side of the TPMO line. The licensed broker who contacts the beneficiary after intake is the TPMO or agent of record for the plan presentation. Organizations deploying MediMatch should confirm with their legal counsel that their specific implementation preserves this separation.

Primary Sources

1. 42 CFR §§ 422.2268 and 423.2268 — TPMO definition, disclaimer, recording, and SOA requirements for MA and Part D.
ecfr.gov → 42 CFR § 422.2268
2. CMS Medicare Marketing Guidelines (MMG) — Chapter 3 governs TPMO requirements, disclaimer language, recording obligations, and digital channel rules. Updated annually.
cms.gov → Medicare Marketing Guidelines
3. 42 CFR § 422.2264 — Scope of Appointment requirements for MA plans, including the 48-hour rule and exceptions.
ecfr.gov → 42 CFR § 422.2264
4. 88 FR 22120 (April 5, 2023) — CMS 2023 Final Rule strengthening TPMO requirements, civil monetary penalty authority, and recording mandates.
federalregister.gov → 2023 Final Rule
5. CMS TPMO FAQ (2021) — CMS responses to industry questions on TPMO classification, technology vendor analysis, and disclaimer placement.
cms.gov → TPMO FAQ

Frequently Asked Questions

What is a TPMO under CMS rules?
A Third Party Marketing Organization is any entity that, pursuant to a written arrangement with one or more MA organizations or Part D sponsors, markets, sells, or enrolls Medicare beneficiaries in health benefit plans. This includes FMOs, independent broker agencies, lead aggregators, and technology platforms that present plan options to beneficiaries. The definition is in 42 CFR §§ 422.2268(b) and 423.2268(b).
What is the verbatim TPMO 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 text cannot be paraphrased. It must appear before any plan-specific information is shared.
How long must TPMO call recordings be retained?
Ten years from the date of the recording. This applies to all marketing calls, sales calls, and enrollment calls regardless of channel. Written communications such as SMS logs and emails used in plan marketing must also be retained for 10 years. The requirement is in 42 CFR §§ 422.2268 and 423.2268.
What is a Scope of Appointment and when is the 48-hour rule waived?
A Scope of Appointment documents which product types the beneficiary agreed to discuss before a sales appointment. The 48-hour advance requirement is waived when the beneficiary initiates contact within 48 hours of the appointment (e.g., calls a hotline, submits an online form). The SOA must still be completed before plan options are discussed even in the waiver scenario.
Can a technology platform be classified as a TPMO?
Yes. CMS applies a functional test: if the platform presents plan options, collects beneficiary information for enrollment purposes, or materially assists in a sales transaction under a written arrangement with a plan sponsor, it is likely a TPMO. Purely administrative platforms (CRM, routing only) that do not present plan-specific information are generally outside the definition.
What penalties apply for TPMO non-compliance?
CMS can impose civil monetary penalties of up to $100,000 per violation per beneficiary, suspension of marketing activities, and contract termination for the sponsoring MA organization. The 2023 Final Rule (88 FR 22120) strengthened CMS's CMP authority. Plan sponsors bear downstream liability for TPMO non-compliance under their CMS contracts.
Does the TPMO disclaimer apply to SMS and digital marketing?
Yes. The disclaimer applies to all marketing communications where plan information is presented, including SMS, email, and web interfaces. For SMS programs, the disclaimer must be transmitted before the first plan-specific message. CMS Chapter 3 of the Medicare Marketing Guidelines governs digital channel requirements.
What must a TPMO disclose about compensation?
TPMOs must disclose, upon a beneficiary's request, whether they receive compensation for enrollment referrals and the nature of that compensation (fixed vs. variable, which plans pay more, etc.). This disclosure must be made in plain language before the enrollment is completed. CMS has flagged undisclosed compensation structures as a significant source of beneficiary complaints.