CMS Proposals Address Anti-Competitive Practices in Medicare Advantage

Health Payer Intelligence November 7, 2023
Victoria Bailey

The proposed rule includes a fixed compensation of $632 for agents and brokers helping Medicare Advantage beneficiaries choose a plan.

CMS has proposed provisions to improve protections for Medicare Advantage beneficiaries, prevent anti-competitive practices, and strengthen access to behavioral healthcare services.

The Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program proposed rule includes new guardrails for plan compensation to agents and brokers. Beneficiaries may use agents and brokers to help them choose a new plan. In return, agents and brokers receive compensation from the plans.

Although intended to help people navigate their plan options, agents and brokers may steer beneficiaries toward plans that provide significant compensation rather than those that meet the beneficiary’s health needs.

CMS...

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