On Monday, NAHU sent a letter to the Center for Medicare and Medicaid Services (CMS) regarding Section 120.4.4 of the 2018 Medicare Marketing Guidelines. That guidance was intended to prevent agents and brokers from steering Medicare beneficiaries into plans with higher commissions and to circumvent the prohibited use of administrative fees by agents and brokers. Our comments noted several issues with the proposal, including that it would result in plans no longer paying for performance, disrupt recruiting, training and support structures, and that existing regulations are already in place to ensure agents are not paid in excess of fair market value.
Section 120.4.4 of the guidance addresses additional marketing fees noting, “Plans/Part D Sponsors that choose to pay for items not included in agent/broker compensation must pay at fair market value for services provided, and may not pay on a per-enrollment basis.” This language was added to the marketing guidelines in response to some agents and brokers using administrative fees despite prior guidance prohibiting them. We noted that implementing this regulation would result in eliminating fees critical to the distribution system for Medicare Advantage and Part D, create a bigger problem in how a carrier funds distribution management, and would affect management of distribution and administrative fees that are paid based on performance.
Additionally, we noted our opposition to the proposed website requirement that plans and sponsors submit third-party marketing websites and online forms that need to be filled out to receive more information on Medicare Advantage or prescription drug plan names or logos, even if there is no benefit information included. We noted that implementing this requirement would be nearly impossible, and given the prevalence of social media, any mention of a plan would impede the ability of agents to educate Medicare beneficiaries and that simply mentioning that an agent sells plans and providing a "Contact Me" form is an overreach by CMS. NAHU expects an updated version of the 2018 Medicare Marketing Guidelines to be released this summer, and will update you as any changes are made.