{"id":4041,"date":"2024-08-09T14:45:56","date_gmt":"2024-08-09T19:45:56","guid":{"rendered":"https:\/\/www.bluekc.com\/blueprint\/?p=4041"},"modified":"2024-08-12T14:47:23","modified_gmt":"2024-08-12T19:47:23","slug":"cms-announces-system-changes-to-stop-unauthorized-agent-marketplace-activity","status":"publish","type":"post","link":"https:\/\/www.bluekc.com\/blueprint\/gated-agent\/cms-announces-system-changes-to-stop-unauthorized-agent-marketplace-activity\/","title":{"rendered":"CMS announces system changes to stop unauthorized agent Marketplace activity"},"content":{"rendered":"\n<p>The Centers for Medicare &amp; Medicaid Services (CMS) announced a <a href=\"https:\/\/www.cms.gov\/newsroom\/press-releases\/cms-statement-system-changes-stop-unauthorized-agent-and-broker-marketplace-activity\" target=\"_blank\" rel=\"noreferrer noopener\">system change<\/a> to Healthcare.gov that will block an agent from making changes to a consumer\u2019s federal Marketplace enrollment unless the agent is already associated with the consumer\u2019s enrollment. Agents not already associated with a consumer\u2019s enrollment must now take additional steps to update a consumer\u2019s enrollment, including conducting a three-way call with the consumer and the Marketplace Call Center. The change is being implemented to address the increases in unauthorized enrollments and plan switching by agents.<\/p>\n\n\n\n<p>CMS will also implement a new weekly process to identify and cancel new (often duplicate) enrollments submitted by agents and brokers who are not associated with the consumer\u2019s enrollment. Consumers and agents will be made aware of these cancellations when they receive a notice from the issuer cancelling the invalid enrollment.<\/p>\n\n\n\n<p>For technical information about the changes associated with this update and impacts to issuers, please see CMS\u2019s <a href=\"https:\/\/zone.cms.gov\/system\/files\/documents\/Release%20Notes%20for%20NPN%20Switching%2007192024%20final_1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Release Notes for NPN Switching<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Why the change?<\/strong><\/h2>\n\n\n\n<p>CMS reported that in the first six months of 2024 the Marketplace received 73,884 complaints of unauthorized plan switches and 134,368 complaints of unauthorized enrollments. Since June, CMS has issued 200 suspensions of agent or broker Marketplace Agreements for reasonable suspicion of fraud or abusive conduct related to unauthorized enrollments and plan switching, prohibiting such agents from participating in the Marketplace enrollment process.<\/p>\n\n\n\n<p>We expect these changes to significantly decrease new unauthorized enrollment activity through the Marketplace.<\/p>\n\r\n\t\t\t<div id=\"daexthefu-container\"\r\n\t\t\t\tclass=\"daexthefu-container daexthefu-layout-side-by-side daexthefu-alignment-left\"\r\n\t\t\t\tdata-post-id=\"4041\">\r\n\r\n\t\t\t\t<div class=\"daexthefu-feedback\">\r\n\t\t\t\t\t<div class=\"daexthefu-text\">\r\n\t\t\t\t\t\t<h3 class=\"daexthefu-title\">Was this helpful?<\/h3>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<div class=\"daexthefu-buttons-container\">\r\n\t\t\t\t\t\t<div class=\"daexthefu-buttons\">\r\n\t\t\t\t\t\t\t\r\n\t\t\t<div class=\"daexthefu-yes daexthefu-button daexthefu-button-type-icon\" 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class=\"daexthefu-comment-label\"><\/label>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"daexthefu-comment-character-counter-container\">\r\n\t\t\t\t\t\t\t\t<div id=\"daexthefu-comment-character-counter-number\"\r\n\t\t\t\t\t\t\t\t\tclass=\"daexthefu-comment-character-counter-number\"><\/div>\r\n\t\t\t\t\t\t\t\t<div class=\"daexthefu-comment-character-counter-text\"><\/div>\r\n\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<textarea id=\"daexthefu-comment-textarea\" class=\"daexthefu-comment-textarea\"\r\n\t\t\t\t\t\t\t\tplaceholder=\"Type your message\"\r\n\t\t\t\t\t\t\t\tmaxlength=\"\r\n\t\t\t\t\t\t\t\t400\t\t\t\t\t\t\t\t\t\"><\/textarea>\r\n\t\t\t\t\t<div class=\"daexthefu-comment-buttons-container\">\r\n\t\t\t\t\t\t<button class=\"daexthefu-comment-submit daexthefu-button\">Submit<\/button>\r\n\t\t\t\t\t\t<button class=\"daexthefu-comment-cancel daexthefu-button\">Cancel<\/button>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<div class=\"daexthefu-successful-submission-text\">Thanks for your feedback!<\/div>\r\n\r\n\t\t\t<\/div>\r\n\r\n\t\t\t","protected":false},"excerpt":{"rendered":"<p>The Centers for Medicare &amp; Medicaid Services (CMS) announced a system change to Healthcare.gov that will block an agent from making changes to a consumer\u2019s federal Marketplace enrollment unless the agent is already associated with the consumer\u2019s enrollment. Agents not&#8230;<\/p>\n","protected":false},"author":26,"featured_media":4046,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_helpful_status":1,"_analytify_skip_tracking":false,"footnotes":""},"categories":[3,7],"tags":[58],"post-on-community-impact":[],"class_list":["post-4041","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-broker-resources","category-gated-agent","tag-agents-ifp-aca"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.1.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>CMS announces system changes to stop unauthorized agent Marketplace activity - The Blueprint<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bluekc.com\/blueprint\/gated-agent\/cms-announces-system-changes-to-stop-unauthorized-agent-marketplace-activity\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS announces system changes to stop unauthorized agent Marketplace activity - The Blueprint\" \/>\n<meta property=\"og:description\" content=\"The Centers for Medicare &amp; Medicaid Services (CMS) announced a system change to Healthcare.gov that will block an agent from making changes to a consumer\u2019s federal Marketplace enrollment unless the agent is already associated with the consumer\u2019s enrollment. 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