Commenters Say Proposed Changes to MA Agent, Broker Pay Are ‘Detrimental’

Although new policies proposed by CMS aim to protect Medicare beneficiaries by clamping down on fees that promote anticompetitive sales practices, critics of the proposed rule say CMS’s actions inappropriately target agents and brokers who sell Medicare Advantage plans and the field marketing organizations (FMOs) that support them. Further, they warn that CMS’s proposed changes to agent and broker reimbursement could lead to significant industry disruption that would trickle down to beneficiaries. 

The proposed rule was issued on Nov. 6 and published in the Nov. 15 Federal Register and contained provisions aimed at improving access to behavioral health, enhancing transparency around supplemental benefits, streamlining enrollment options for dual eligibles, encouraging biosimilar product substitution, and assessing the impact of prior authorization policies on health equity. CMS accepted comments through Jan. 5, and it received hundreds of comment letters addressing the rule’s more controversial proposals seeking to place new limits on agent and broker compensation.