What Is a TPMO?
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
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.
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✓TPMO disclaimer — Verbatim disclosure that the TPMO does not represent all plans must be delivered before any plan-specific information is shared.
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✓Recording + 10-year retention — All marketing calls, sales calls, and enrollment calls must be recorded and retained for 10 years.
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✓Scope of Appointment — Documentation of which product types the beneficiary agreed to discuss, obtained before the sales appointment.
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✓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
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.
"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."
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
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 |
| Retain | Marketing emails involving plan information must be retained in the same 10-year window |
Scope of Appointment Requirements
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?
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
ecfr.gov → 42 CFR § 422.2268
cms.gov → Medicare Marketing Guidelines
ecfr.gov → 42 CFR § 422.2264
federalregister.gov → 2023 Final Rule
cms.gov → TPMO FAQ