News Briefs: Wyden’s Latest Medicare Marketing Report Suggests CMS Regulate Third-Party Marketers

Apr 03
Apr 03, 2025

A new report from Senate Finance Committee Democrats said Medicare Advantage insurers spent $6.9 billion on fees and commissions to agents and brokers in 2023, up from $2.4 billion in 2018, and offered multiple recommendations to protect Medicare consumers from “predatory” third-party marketing tactics. The report, Pushing Medicare Advantage on Seniors: Unraveling the Complex Network of Marketing Middlemen, summarized “quantitative data” gathered through interviews, hearings and information collected from the National Association of Insurance Commissioners, major insurers and third-party marketing organizations (TPMOs). As chair of the Senate Finance Committee, Sen. Ron Wyden (D-Ore.) in 2022 issued a similar report based on an investigation of Medicare marketing practices and in 2024 issued letters to five TPMOs seeking information on their data collection and enrollment practices. More than a year later, the committee ranking member released the report, which criticized the practice of lead purchasing and generating. Its review of one TPMO-insurer marketing agreement found that the amount of purchased leads grew by 269% between 2018 and 2022, while another reported an increase of 706% during the same period. Among other things, the report recommended that Congress grant CMS authority to directly regulate marketing organizations and lead generators and allow MA plans to contract only with marketing and lead generation companies that are approved by CMS. It also suggested holding brokers, lead generators and insurers up to new standards by penalizing individuals or companies involved in the chain of enrollment who violate CMS requirements. Penalties could be financial, loss of renewal commissions, loss of licensure and “jail time if appropriate,” suggested the report.
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Lauren Flynn Kelly

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.