Medicare pay per call: CMS rules and the stack (2026)

Medicare is the most regulated pay-per-call vertical. CMS rules on third-party marketing organizations (TPMOs) apply on top of the TCPA, and the CY2027 rule changed the TPMO disclaimer for marketing starting October 1, 2026.

Updated Nov 1, 2026 · General information, not legal advice.

Key dates

  • Annual Enrollment Period (AEP): October 15 to December 7
  • Medicare Advantage Open Enrollment Period: January 1 to March 31
  • CY2027 marketing rules apply to marketing from October 1, 2026

CMS rules that shape the call

TPMOs must give CMS's standardized disclaimer (42 CFR 422.2267(e)(41)). Under the CY2027 rule (91 FR 17583, April 6, 2026), the disclaimer must be given before benefits are discussed, and the reference to SHIP was removed from it. 42 CFR 422.2274 requires recording marketing, sales and enrollment calls with beneficiaries in their entirety, and covers how TPMOs work with plans, agents and brokers.

The CY2025 rule requires prior express written consent, given one TPMO at a time, before a TPMO shares a beneficiary's personal data with another TPMO. A Texas federal court vacated other parts of that rule in August 2025 but left this requirement in place.

What to build into your flow

  • Play the TPMO disclaimer before any benefits are discussed
  • Record every call end to end and keep the recordings for the required period
  • Get TPMO-specific written consent before passing beneficiary data to another TPMO
  • Scrub DNC and litigator lists, and check the Reassigned Numbers Database, before outbound calls
  • Use consent-proof certificates on every web form

Tools to look at

Frequently asked questions

When is the Medicare AEP in 2026?

October 15 to December 7, 2026, per Medicare.gov. The Medicare Advantage Open Enrollment Period runs January 1 to March 31.

What changed for TPMOs in the CY2027 rule?

For marketing starting October 1, 2026, the TPMO disclaimer must be given before benefits are discussed, and the reference to SHIP was removed. Read the April 6, 2026 Federal Register rule for the exact text.

Is the one-to-one consent rule still in effect for Medicare?

The FCC's TCPA one-to-one rule was vacated in January 2025. CMS's separate TPMO data-sharing consent requirement, from the CY2025 rule, was upheld and still applies.

Sources

Related