- A major field marketing organization is suing the Biden administration over a final rule capping payments from Medicare Advantage health insurers to agents and brokers, joining a raft of other litigation from sales groups seeking to roll back the regulation.
- In its suit filed last week in a Texas district court, AmeriLife argues the government doesn’t have the authority to cut off payments to field marketing organizations, or FMOs, which don’t themselves enroll beneficiaries in plans but use payments from carriers to oversee independent brokers that do.
- AmeriLife is seeking either a declaration that the rule does not apply to payments paid from MA plans to FMOs that aren’t passed along to agents and brokers, or an order preventing the rule from applying to those payments. And the clock is ticking — according to the suit, uncertainty around the regulation has prevented FMOs like AmeriLife from negotiating time-sensitive contracts with MA payers for the upcoming plan year.
Medicare Advantage sales middleman sues HHS over rule capping broker compensation
AmeriLife’s suit joins at least two others from MA sales groups seeking revisions to the rule for threatening their business model. It also comes with a ticking clock, given a looming deadline for marketing contract negotiations.
