CMS to review Medicare Advantage sales commissions

Troubled by reports that commissions are skyrocketing, CMS officials said last week that they plan to look into the way agents and brokers are compensated by Medicare insurers.

Right now, about 10 million seniors and disabled people are enrolled in Medicare Advantage, under which Medicare-eligible consumers can enroll in private insurance plans. However, critics have begun to raise questions about how brokers and agents actually get patients to enroll--and whether the size of the commissions involved may be prompting them to sell too aggressively and enroll patients in plans that don't suit them.

According to research by one news organization, agents can make $500 to $550 to enroll a beneficiary in some plans, plus $500 per year for each year the patient stays with the plan. Doling out a $2,500 payment for five years is a big increase from previous years, researchers say.

Now, a wide range of industry stakeholders, including Rep. Pete Stark (D-CA), Humana and UnitedHealth Group, are calling on CMS to cap commissions--and CMS says it plans to do so. In the meantime, CMS has recently issued regulations designed to check abusive sales practices for Medicare Advantage plans, which will take place when the plans' marketing season begins November 15.

To find out more about CMS's plans:
- read this Modern Healthcare piece [1]

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