CMS Draft Legislation for CY 2026

 
The Friday Five for January 17, 2025:
TikTok Ban & Popular Alternatives
Part D Cost-Sharing
Successor Regulation Rules
Creditable Coverage Determination
MA and Part D Advance Notice
 
TikTok Ban & Rising Alternatives:
“A Possible Tiktok Ban Is Just Days Away. A List of Other Apps Available.” Apnews.Com, AP News, 14 Jan. 2025, apnews.com/article/tiktok-alternative-social-media-platforms-ban-49af1bfd2a1543a09b327544c380f217.
Rosenblatt, Kalhan. “Chinese TikTok Alternative RedNote Tops App Charts Ahead of Potential TikTok Ban.” NBCNews.Com, NBCUniversal News Group, 14 Jan. 2025, www.nbcnews.com/tech/social-media/rednote-chinese-tiktok-alternative-tops-app-charts-ahead-ban-rcna187497.
Habeshian, Sareen. “Tiktok Ban Timeline: Here’s Where Things Stand.” Axios.Com, Axios, 13 Jan. 2025, www.axios.com/2025/01/13/tiktok-ban-timeline.
“TikTok Prepares for US Shutdown from Sunday, Sources Say.” Reuters.Com, Reuters, 15 Jan. 2025, www.reuters.com/technology/tiktok-preparing-us-shut-off-sunday-information-reports-2025-01-15/.
 
CMS Draft CY 2026 Part D Redesign Program:
“CMS Releases Proposed 2026 Payment Policy Updates for Medicare Advantage and Part D Programs.” CMS.Gov, Centers for Medicare & Medicaid Services, 10 Jan. 2025, www.cms.gov/newsroom/press-releases/cms-releases-proposed-2026-payment-policy-updates-medicare-advantage-and-part-d-programs.
“Draft CY 2026 Part D Redesign Program Instructions Fact Sheet.” CMS.Gov, Centers for Medicare & Medicaid Services, 10 Jan. 2025, www.cms.gov/newsroom/fact-sheets/draft-cy-2026-part-d-redesign-program-instructions-fact-sheet.
“Draft CY 2026 Part D Redesign Program Instructions.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/draft-cy-2026-part-d-redesign-program-instructions.pdf. Accessed 14 Jan. 2025
“Final CY 2025 Part D Redesign Program Instructions.” Cms.Gov, Centers for Medicare & Medicaid Services, 10 Jan. 2025, www.cms.gov/files/document/final-cy-2025-part-d-redesign-program-instructions.pdf.
 
CMS 2026 Medicare Advantage and Medicare Part D Advance Notice:
“2025 Medicare Advantage and Part D Advance Notice Fact Sheet.” Cms.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/2025-advance-notice-fact-sheet-and-faq.pdf. Accessed 14 Jan. 2025.
“2025 Medicare Advantage and Part D Rate Announcement.” CMS.Gov, Centers for Medicare & Medicaid Services, 1 Apr. 2024, www.cms.gov/newsroom/fact-sheets/2025-medicare-advantage-and-part-d-rate-announcement.
“2026 Medicare Advantage and Part D Advance Notice Fact Sheet.” CMS.Gov, Centers for Medicare & Medicaid Services, 10 Jan. 2025, www.cms.gov/newsroom/fact-sheets/2026-medicare-advantage-and-part-d-advance-notice-fact-sheet.
“Advance Notice of Methodological Changes for Calendar Year (CY) 2026 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.” Cms.Gov, Centers for Medicare & Medicaid Services, 10 Jan. 2025, www.cms.gov/files/document/2026-advance-notice.pdf.
Goldman, Maya. “Biden Proposes $21B Pay Increase for MA Insurers.” Axios.Com, Axios, 13 Jan. 2025, www.axios.com/2025/01/13/biden-proposes-insurer-pay-increase .
Pifer, Rebecca. “CMS Revised Medicare Advantage Star Ratings. Here’s Which Payers Benefited.” Healthcaredive.Com, Healthcare Dive, 9 July 2024, www.healthcaredive.com/news/cms-revised-medicare-advantage-star-ratings-plan-scores/720697/.
 
Resources:
2025 ACA Enrollment Updates: https://lnk.to/asgf20250110
CMS Announces Part D Savings & 2026 Maximum Fair Prices for First 10 Medicare-Negotiated Drugs: https://lnk.to/BkBrUZ 
How to Find Balance Between Life & Work: https://ritterim.com/blog/how-to-find-balance-between-life-and-work/
Instagram Basics for Insurance Agents: https://lnk.to/asg634  
The Medicare Part D Creditable Coverage Determination Changes for 2025 or Beyond: https://ritterim.com/blog/the-medicare-part-d-creditable-coverage-determination-changes-for-2025-or-beyond/
Top 5 Apps of 2024: https://lnk.to/QkLB8T
Why Gen Z is a Good Fit for Selling Insurance: https://lnk.to/asg640
 
Follow Us on Social!
Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://twitter.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance    
Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel 
Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/
 
Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.
 
Not affiliated with or endorsed by Medicare or any government agency.

2025 ACA Enrollment Updates

 
 
January 10, 2025:
Sarah’s 2025 Goals
Highlights from CES 2025
First HIPAA Update Since 2013
ACA DACA Enrollment Eligibility Update
2025 ACA Enrollment Snapshot #2
 
Sarah’s 2025 Goals:
Cement City: https://www.cementcity.org/
 
Highlights from CES 2025:
Carlson, Jeff. “CES 2025: We’re Obsessed With These 28 New Products So Far.” CNET.Com, CNET, 9 Jan. 2025, www.cnet.com/pictures/ces-2025-were-obsessed-with-these-28-new-products-so-far/.
Kastrenakes, Jacob. “CES 2025: All the News, Gadgets, and Surprises.” Theverge.Com, The Verge, 4 Jan. 2025, www.theverge.com/2025/1/4/24307731/ces-2025-tvs-gaming-smart-home-wearables-news.
Halliday AI Glasses: https://hallidayglobal.com/products/reservation 
Ortiz, Sabrina. “Halliday Just Unveiled the AI Glasses That Meta, Google and Apple Have Been Trying to Build.” ZDNET.Com, ZDNET, 8 Jan. 2025, www.zdnet.com/article/halliday-just-unveiled-the-ai-glasses-that-meta-google-and-apple-have-been-trying-to-build/.
Mirumi: https://mirumi.ux-xu.com/
Segway Navimov X3 Series: https://navimow.segway.com/uk/product/navimow-x.html
Stolyar, Brenda. “The 31 Best Gadgets From CES 2025 You Can Buy Right Now.” Wired.Com, Conde Nast, 9 Jan. 2025, www.wired.com/story/the-gadgets-from-ces-2025-you-can-buy-right-now/.
Weatherbed, Jess. “These Smart Glasses Have a Tiny Little Screen Hidden in the Frame.” Theverge.Com, The Verge, 6 Jan. 2025, www.theverge.com/2025/1/5/24334030/halliday-smart-glasses-ai-tiny-display-frame-availability-price-ces.
 
First HIPAA Update Since 2013:
Olsen, Emily. “HHS Proposes HIPAA Update to Boost Healthcare Cybersecurity.” Healthcaredive.Com, Healthcare Dive, 3 Jan. 2025, www.healthcaredive.com/news/hhs-hipaa-security-rule-update-cybersecurity/736451/.
Beavins, Emma. “HHS Proposes New Cybersecurity Requirements as First Major HIPAA Update in 10 Years.” Fiercehealthcare.Com, Fierce Healthcare, 7 Jan. 2025, www.fiercehealthcare.com/regulatory/hhs-proposes-cybersecurity-updates-healthcare-organizations.
“HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information.” Federalregister.Gov, Federal Register, 6 Jan. 2025, www.federalregister.gov/documents/2025/01/06/2024-30983/hipaa-security-rule-to-strengthen-the-cybersecurity-of-electronic-protected-health-information.
 
ACA DACA Enrollment Eligibility Update:
“DACA Eligibility Update.” Khbe.Ky.Gov, Kynect Health Coverage, khbe.ky.gov/Agents-kynectors/Documents/kynector-FAQ.pdf. Accessed 9 Jan. 2025.
“HHS Final Rule Clarifying the Eligibility of Deferred Action for Childhood Arrivals (DACA) Recipients and Certain Other Noncitizens.” CMS.Gov, Centers for Medicare & Medicaid Services, 3 May 2024, www.cms.gov/newsroom/fact-sheets/hhs-final-rule-clarifying-eligibility-deferred-action-childhood-arrivals-daca-recipients-and-certain.
“Immigration Status to Qualify for the Marketplace.” HealthCare.Gov, Centers for Medicare & Medicaid Services, www.healthcare.gov/immigrants/immigration-status/. Accessed 9 Jan. 2025.
“Kansas et al. v. United States of America et Al..” Litigationtracker.Law.Georgetown.Edu, Georgetown University, 2 Jan. 2025, litigationtracker.law.georgetown.edu/litigation/kansas-et-al-v-united-states-of-america-et-al/.
Pillair, Drishti, and Samantha Artiga. “Overview and Implications of the ACA Marketplace Expansion to DACA Recipients.” KFF.Org, KFF, 6 Jan. 2025, www.kff.org/racial-equity-and-health-policy/issue-brief/overview-and-implications-of-the-aca-marketplace-expansion-to-daca-recipients/.
“Recent Court Decisions Impacting the Marketplace.” HealthCare.Gov, Centers for Medicare & Medicaid Services, www.healthcare.gov/court-decisions/. Accessed 9 Jan. 2025.
“State-Based Marketplaces: 2025 Open Enrollment.” CMS.Gov, Centers for Medicare & Medicaid Services, 17 Oct. 2024, www.cms.gov/files/document/state-exchange-oe-chart-py-2025.pdf.
“State Health Insurance Marketplace Types, 2025.” KFF.Org, KFF, 26 Oct. 2024, www.kff.org/affordable-care-act/state-indicator/state-health-insurance-marketplace-types/.
“State of Kansas, et al. Appellees v. United States of America and Centers for Medicare & Medicaid Services Appellants.” Litigationtracker.Law.Georgetown.Edu, Georgetown University, litigationtracker.law.georgetown.edu/wp-content/uploads/2024/12/Kansas_2024.12.16_ORDER.pdf. Accessed 9 Jan. 2025.
 
2025 ACA Enrollment Snapshot #2:
“Marketplace 2024 Open Enrollment Period Report: Final National Snapshot.” CMS.Gov, Centers for Medicare & Medicaid Services, 24 Jan. 2024, www.cms.gov/newsroom/fact-sheets/marketplace-2024-open-enrollment-period-report-final-national-snapshot.
“Marketplace 2025 Open Enrollment Period Report: National Snapshot.” CMS.Gov, Centers for Medicare & Medicaid Services, 8 Jan. 2025, www.cms.gov/newsroom/fact-sheets/marketplace-2025-open-enrollment-period-report-national-snapshot-1.
“Nearly 24 Million Consumers Have Selected Affordable Health Coverage in ACA Marketplace, With Time Left to Enroll.” CMS.Gov, Centers for Medicare & Medicaid Services, 8 Jan. 2025, www.cms.gov/newsroom/press-releases/nearly-24-million-consumers-have-selected-affordable-health-coverage-aca-marketplace-time-left.
 
Resources:
5 Tips for Finding Supplemental Coverage for ACA Plans: https://lnk.to/xDtALf
Lessons Learned in 2024: https://lnk.to/asg637
Marketing Trends for 2025: https://lnk.to/asg639
Setting SMART Goals in 2025: https://lnk.to/asgf20250103
Why Gen Z is a Good Fit for Selling Insurance: https://lnk.to/asg640
 
Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.
 
Follow Us on Social! 
Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://twitter.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance    
Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel 
Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/
 
Not affiliated with or endorsed by Medicare or any government agency.

Top 5 Episodes of 2024

 
Join Sarah as she counts down the top 5 Agent Survival Guide Podcast episodes of 2024! Find out if your favorite episode made the cut… and thanks for listening this year!
 
Number Five: [02:22]
Number Four: [21:29]
Number Three: [31:18]
Number Two: [39:18]
Number One: [01:04:19]
 
Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.
 
Follow Us on Social! 
Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://twitter.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance    
Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel 
Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/
 
Links to Individual Episodes:
5 Perks of Being a Part-Time Insurance Agent: https://pod.fo/e/28ab20
Agent’s Guide to Email Communication Resources: https://pod.fo/e/28ab27
Developing a Retention Mindset ft. Blake Amos: https://pod.fo/e/28ab52
Key Changes for ACA Open Enrollment 2025 ft. Ross Baker: https://pod.fo/e/28aaeb
Using a SWOT Analysis to Review Your Insurance Business: https://pod.fo/e/28ab7f
 
Additional Episodes You Might Like:
5 Things About Prepping for the Insurance License Exam: https://pod.fo/e/28ab2c
9 Essential Tools for Beginner Insurance Agents: https://pod.fo/e/28ab2e
How Much Can Agents Make Selling Under-65 Insurance: https://pod.fo/e/28aaf7
Simplify Marketplace Enrollments with HealthSherpa: https://pod.fo/e/27a351
Steps to Get Ready for OEP: Federal & State Exchanges: https://pod.fo/e/28aaf6
What Today's Financial Environment Means for Medicare Beneficiaries & Agents: https://pod.fo/e/28aafb
 
Resources for Insurance Agents:
Developing an Agency — Your Guide to Getting Started: https://www.ritterim.com/agency-guide/
Email Template for Client Check-in: https://ritterim.com/documents/client-check-in-email-template.docx
FMO vs. IMO vs. NMO vs. MGA vs. GA: What’s the Difference? https://ritterim.com/blog/fmo-vs-imo-vs-nmo-vs-mga-vs-ga-whats-the-difference/
How Professional Organizations Make You a Better Agent: https://ritterim.com/blog/how-professional-organizations-make-you-a-better-agent/
Increase Sales and Productivity with the Busy Medicare Agent’s Sales Planner: https://www.ritterim.com/blog/increase-sales-and-productivity-with-the-busy-medicare-agents-sales-planner/
Modern Medicare Marketing for Today's Agents: https://www.ritterim.com/modern-marketing-guide/
Request a Portfolio Review from Ritter Insurance Marketing: https://ritterim.com/portfolio/
Ritter Agent Handbook: https://docs.ritterim.com/documents/compliance/Ritter-Agent-Handbook-2024.pdf
Ritter Insurance Marketing Official Site: https://ritterim.com/
Stay Organized with the Busy ACA Agent’s Sales Calendar: https://www.ritterim.com/blog/stay-organized-with-the-busy-aca-agents-sales-calendar/
The Complete Guide to Client Loyalty and Retention: https://ritterim.com/client-retention-guide/
The Complete Guide to Selling Affordable Care Act Insurance Plans: https://ritterim.com/aca-ebook/
The Ultimate Agent Resource List Pt. 1: Market Yourself: https://www.ritterim.com/blog/the-ultimate-agent-resource-list-pt.-1-market-yourself/
Your Step-By-Step Guide to Getting Started in Insurance Sales: https://ritterim.com/free-guide/?utm_source=asg_podcast_link
 
Not affiliated with or endorsed by Medicare or any government agency.
 
The resources in Agent's Guide to Email Communication Reesources are the opinions of staff and agents who work with Ritter Insurance Marketing. We cannot guarantee that an agent’s business will succeed if utilizing these recommendations. An agents is solely responsible for making all decisions and taking actions related to their business.