Take Action: PIA urges CMS Action to Address Emerging Medicare Practices

On By Corey Weeks, Manager, Government Relations

On November 12, PIA sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz urging the agency to address concerning trends in the Medicare Advantage and Medicare Part D markets that threaten consumer access, undermine market integrity, and marginalize the role of licensed insurance agents. Take action here to make your voice heard!

Across the country, seniors are facing reduced access to quality Medicare plans as carriers implement troubling strategies—including removing enrollment applications from websites, discouraging producers from selling certain products, and slashing agent compensation mid-year. These actions not only destabilize the marketplace but also jeopardize the ability of seniors to receive trusted, professional guidance when selecting coverage.

The Idaho Department of Insurance took action to address these concerning practices, issuing Bulletin No. 25-06, which identifies these practices as unfair trade practices and outlines clear expectations for carrier conduct. Specifically, the bulletin requires:

  • Enrollment applications to be accessible both online and in print.
  • Carriers refrain from discouraging producers from marketing or selling their products.
  • Compensation structures remain consistent throughout the plan year, especially when built into rate development.

PIA commends Idaho’s leadership in advancing this framework and urges CMS to adopt similar standards to protect consumers and uphold fair competition. In its letter, PIA urged CMS to take these substantive actions:

  • Investigate carrier practices that reduce agent compensation or restrict access to filed products.
  • Issue guidance clarifying CMS’s position on mid-year commission changes and producer access.
  • Promote transparency in carrier compensation policies, including advance notice and justification for changes.

Licensed insurance agents play a vital role in helping Medicare beneficiaries navigate complex coverage options. Undermining their ability to serve consumers not only harms seniors but erodes the integrity of the Medicare marketplace. PIA stands ready to work with CMS, state regulators, and industry stakeholders to implement reforms that protect consumers and preserve the essential role of agents.