CMS Fair Market Value Compensation paid to Agents or Brokers

[KCFL23]

According to 42 C.F.R. §§422.2274 (d) (2) and 423.2274 (d) (2), the compensation amount an organization pays to an independent agent or broker for an enrollment must be at or below the fair market value (FMV) cut-off amounts published yearly by the Center for Medicare and Medicaid Services (CMS).

Would a Medicare Carrier (UHC, Humana, Aetna, Wellcare,...) be in violation of the Fair Market Value rules if they made private agreements with certain agents and brokers in a market, but not all agents and brokers in making compensation arrangements that are based on the number of Medicare or Medicaid beneficiaries who are enrolled in a plan?

 

[KCFL23]

I am surprised to have received as many views but no responses. If you sell Medicare Advantage Plans, are you ok with another agent receiving a higher commission for selling the same plan you sell just because the carrier representative decided to choose which agent to pay a higher commissions? The Fair Market Value commission rules set by CMS were developed to keep agents for steering prospects to certain plans based on the commission the agent would receive. If carriers, can create private agreements with agents to pay a higher commission if they steer a prospect to a certain plan, then that would be a violation of the Fair Market rules set by CMS.