October 16,2008

Baucus Calls For CMS Action To Stop Excessive Commissions For Medicare Advantage Agents

Washington, DC – Senate Finance Committee Chairman Max Baucus (D-Mont.) today condemned the excessively high commissions some Medicare Advantage (MA) plans have announced they will offer agents during the upcoming enrollment period. Baucus said these incentives encourage agents to enroll seniors in a new MA plan even if the plan does not provide better coverage or benefits. A long-time champion of stronger MA marketing regulations,Baucus authored provisions in the Medicare Improvements for Patients and Providers Act(MIPPA) of 2008 that would limit the commissions insurers can offer sales agents. Baucus said today that legislation gives CMS the authority to limit the recently announced commission increases to protect beneficiaries. He called on the agency to take immediate action before the upcoming enrollment period begins on November 15, 2008.

“Giving agents an incentive to switch Medicare beneficiaries into a new plan puts seniors at risk of having fewer benefits and higher costs,” Baucus said. “Medicare Advantage plans that have nearly quadrupled agent commissions are putting profits before patients and that’s wrong. If these insurance companies aren’t going to make sure they are looking out for seniors’ then I’m going to make sure CMS does it for them. I wrote the law that gives CMS the authority to limit agent commissions and I expect them to use it. CMS must act fast and take the decisive action required before the enrollment period begins in November.We can’t let seniors remain at risk of being targeted by predatory sales agents looking tomake a quick buck.

“Excessively increasing agent commissions shows more than a lack of concern for beneficiary interests,” Baucus continued. “These sky-high commissions show just how large Medicare Advantage plan profit margins really are. As Chairman of the Finance Committee, it is my responsibility to make sure Medicare Advantage plans are not making excessive profits at the expense of American taxpayers. It may be time for Congress to reexamine MA payment rates next year.”

For several years, Baucus repeatedly called for CMS rules to limit aggressive and inappropriate Medicare Advantage marketing practices. In September 2008, CMS instituted a rule to require an insurance broker’s commission to be the same whether the agent enrolled a senior in a new plan or the same plan in each successive enrollment period. This policy was meant to eliminate the incentive for brokers to encourage seniors to change plans, thereby keeping seniors in the same plan in an effort to facilitate continued care and coverage. In July 2008, Baucus passed the Medicare Improvements for Patients and Providers Act (MIPPA) that directed CMS to promulgate rules to limit the commissions that insurers can offer sales agents and provided broad authority for the agency to ensure MA plan practices are in the best interest of Medicare beneficiaries.

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