Medicare Commission Dispute Update: CMS’ Repsonse What Agents Need to Know
The growing conflict between insurers and state regulators has caused federal officials to step in to clarify who controls Medicare Advantage (MA) marketing practices. The latest Medicare commission dispute update dives in to CMS’ response to the current status of broker commissions. Several insurers have reduced or eliminated commissions and restricted access to enrollment tools. Therefore, state commissioners are pushing back, arguing these actions harm both agents and beneficiaries. CMS’ latest memo signals that the debate is far from over.
Medicare Advantage Enrollment Suppression
In recent months, multiple insurers have attempted to limit what they view as costly Medicare Advantage enrollment by adjusting broker compensation and curbing access to online enrollment portals. These moves have prompted roughly a dozen states to urge insurers to reverse course. Some state departments even issued cease-and-desist orders, sparking lawsuits from carriers.
On December 4, CMS issued a memo stating; regulation of Medicare Advantage and Part D ultimately rests at the federal level. The agency emphasized that federal law likely preempts state law on matters related to MA compensation and marketing. CMS also reminded stakeholders that commissions are negotiable annually, as long as they fall within federal limits.
Access to Enrollment Forms
Importantly, CMS did clarify one requirement: enrollment forms must remain accessible on insurers’ websites. This comes amid concerns that restricted access to online tools could limit beneficiaries’ ability to make informed choices.
Agents; join the team at Crowe – click here for online contracting
Agent Compensation
While CMS’ memo reaffirmed federal authority, states are unlikely to stay silent. Several state regulators have said they lack the authority to mandate compensation changes but continue urging insurers to restore commissions. Industry observers expect states to keep applying public pressure, even if their legal power is limited. Some also suggest states could focus attention on the Medicare Supplement market, which is regulated at the state level, especially as some carriers consider commission changes in that space as well.
Agents and brokers have voiced growing frustration as certain insurers have reduced or eliminated commissions; sometimes even retroactively. Many argue that these cuts ultimately hurt beneficiaries by reducing access to professional guidance during enrollment.
Watch a YouTube video – Multiple Medicare Advantage Plans going non-commissionable
The dispute has escalated significantly. Insurers have filed lawsuits in response to state actions, claiming that limiting commissions is part of their strategy to maintain plan stability amid rising costs. Meanwhile, regulators in several states have urged insurers to reinstate compensation, warning of the broader impact on consumers.
Let’s Sum it Up
With the 2025 Annual Enrollment Period now over and the 2026 window on the horizon, the tension between state regulators, insurers, and federal authorities is shaping what could become a pivotal policy fight. CMS’ memo clarifies federal preemption but leaves the door open for continued pressure from states. For agents, the message is clear: the debate over Medicare Advantage commissions is far from settled. The outcome will have meaningful implications for how the industry operates moving forward.
Leave a Comment