Why Medicare Marketers Must Rethink Lead Quality Amid CMS & FCC Crackdown

The following article is a repost from MedCity News and written by Lisa Leight, Chief Marketing Officer at Convoso.

Lead quality vs. lead volume: What matters most when serving vulnerable populations

The marketing of Medicare plans has been called a secretive maze, an opaque system where well-paid agents and brokers are siphoning away money that would be better spent on delivering high-quality care.

The Senate Finance Committee, noting that fees and commissions for these agents have been growing at a 19% compound annual growth rate, while enrollment in Medicare programs has increased by just 7%, is pledging to pass new rules to bring more transparency to marketing programs.

And they’re not the only policymakers ready to crack down on marketers with unscrupulous practices or operations that lack clarity. The Centers for Medicare and Medicaid Services (CMS) and the Federal Communications Commission (FCC) are closely monitoring marketers.

And one of the things in their sights is the way marketers reach out to potential customers.

For this reason, compliance with relevant laws governing telephone outreach should be viewed as more than a simple regulatory hurdle – it has become a strategic imperative. 

As scrutiny from CMS and the FCC increases, Medicare marketers must rethink how they source, verify, and engage leads. Taking the focus off lead volume and redirecting it to lead quality will help them demonstrate they run an ethical operation.

Failing to do so will result in fines, reputational damage, and eroding profit margins.

Why a high volume approach doesn’t work

High-volume call strategies often prioritize scale over sensitivity, leading to repeated contact and confusion among seniors. To achieve high volume, marketers often rely on low-intent targeting – eg, using outdated or unverified data sources – which increases the chance of calling individuals without legally required opt-in consent. 

Low-quality leads not only waste money, but they also erode trust and increase legal exposure. With tighter enforcement of the Telephone Consumer Protection Act (TCPA) and a wave of related class-action lawsuits already underway, organizations are realizing that cheap leads most often come with hidden costs.

The recent updates to the TCPA, particularly the reduced 10-day opt-out window and the cross-channel revocation rule, which come into effect next year, underscore the need for more transparent, unified, and auditable consent systems. 

But some marketers continue to rely on misleading lead forms, recycled cold-call lists, incentivized data capture, and masked caller IDs. These tactics are not only out of step with consumer expectations but are increasingly non-compliant under tightening FCC and Federal Trade Commission rules. 

Download the report: 5 Key Factors That Build Trust With Seniors

Consent-based, quality leads close more sales while protecting seniors

In healthcare marketing, when it comes to pursuing sales leads, quality beats quantity every time.

A strategic shift for Medicare marketers means harnessing high-intent leads — verified through behavioral data, consent logs, and real-time scoring — to reduce risk and ensure marketers are helping, not harassing, consumers.

Medicare outreach involves decision-making with long-term consequences. Performance-based acquisition models — those focused on enrollments, retention, and actual policy outcomes — only work when a marketer can start with qualified, compliant, and consented leads.  

Furthermore, CMS requires Third-Party Marketing Organizations (TPMOs) to obtain explicit one-to-one consent from beneficiaries before sharing their personal information with another TPMO. This rule is designed to protect consumer privacy and prevent unauthorized data transfers in Medicare marketing, as well as aggressive marketing tactics such as reselling leads or cold calling.

Seniors are a vulnerable population, and protecting them from deceptive ads, excessive outreach, or unauthorized data use should be a top priority for every Medicare marketer.

How Medicare marketers can build trust with AI

Health insurance marketing teams need to modernize lead flows with technology that enables real-time verification and precision targeting, reducing risk and improving outcomes. Artificial intelligence tools can support an updated consent-based strategy.

AI is essential in this new era of compliance-driven marketing. Intelligent dialers and real-time lead scoring systems allow organizations to prioritize outreach to individuals most likely to convert — and to confirm valid consent. AI also helps flag fatigue signals, detect changes in consumer behavior, and even interpret implied opt-out language, all of which are critical under the new TCPA framework. 

Importantly, AI can also help automate the confirmation of opt-outs within the five-minute TCPA grace period, minimizing the risk of inadvertent noncompliance.

Get the Open Enrollment Success Checklist: Choosing the Best Dialing Software

The roadmap to a compliant and effective strategy

Summing up, here are the key takeaways for building a Medicare marketing strategy that better serves seniors while delivering better performance for organizations.

• Audit lead sources and cut ties with any that lack consent transparency. TPMOs [third-party marketing organizations] must obtain prior express written consent through a “clear and conspicuous disclosure” whether dialing manually or via automated dialing technology. 

• Invest in technology that enables real-time consent validation, AI-powered scoring, and multichannel revocation tracking.

• Align teams and vendors around outcomes, not just call volume.

• Build systems that unify suppression lists and opt-out protocols across voice, SMS, and email channels to prepare for 2026.

• Train broadly — not just marketing and contact center teams, but anyone who might receive a revocation request.

Download the 7-Point Compliance Checklist for Medicare Sales & Marketing Success

Compliance isn’t a cost center — it’s a competitive advantage 

With potential fines – whether via the TCPA or CMS – now reaching up to $1,500 per contact or $51,000+ per Do-Not-Call violation, the stakes are too high to cut corners. The industry must embrace more robust opt-in verification, real-time consent tracking, and ethical data sourcing practices. Holding third-party lead vendors accountable is also essential, as liability extends to the contracting business.

By protecting consumers, especially vulnerable seniors, marketers also protect their brand, revenue potential, and opportunities for future growth.

MedCity News is the leading online news source for the business of innovation in healthcare. We offer insight into what’s next and what matters with a mix of breaking news and analysis on startups, and established industry leaders, personalities, policies and the most important deals.

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DISCLAIMER: The information on this page, and related links, is provided for general education purposes only and is not legal advice. Convoso does not guarantee the accuracy or appropriateness of this information to your situation. You are solely responsible for using Convoso’s services in a legally compliant way and should consult your legal counsel for compliance advice. Any quotes are solely the views of the quoted person and do not necessarily reflect the views or opinions of Convoso.