Effective immediately, CMS said July 19 it is blocking agents and brokers from making changes to an individual’s exchange enrollment status unless they are already associated with that enrollment. Unassociated or “new” agents and brokers will need to conduct a three-way call with the consumer and an agency call center to make any changes, or direct the enrollee to make the changes themselves.
In May, the chair of the Senate Finance Committee, Sen. Ron Wyden, urged CMS to do more to stop fraud on the ACA exchanges. In the first six months of 2024, CMS said it received nearly 74,000 complaints about a plan being changed without the enrollee’s consent. Another 134,368 complaints received by the agency allege that individuals were enrolled in a plan without their consent.
Since June 21, CMS has suspended 200 marketplace agents for reasonable suspicion of fraud or abusive conduct related to enrollment issues.
