Is the New 2025 CMS Rule for Agent compensation actually GREAT news for AGENTS and FMOs?

[GoPokes]

Talked to Ambetter compliance today . They’ve sent cease and desist orders to several massive fmo outfits ( she told me the name of a few but I won’t say who)signing people up with deceiving bs ads . She told me if they don’t stop using they’ll term there contracts . She told many complaints they get on agents they forward to the dept of insurance . She said one thing these unscrupulous agents are doing is flipping the client to another carrier for a month then moving them back to Ambetter 30 days later to be the Aor . There working on there software to detect this and not let them be the Aor

Hmm, I wonder if they are all talk, or if they will follow through. Cease and desist sent to an FMO that is looking at going out of business... sounds like a scare tactic. I doubt they do anything... can they do anything? They say they can term the contract, but have they?

 

[DonP]

Why no names?

I wish not to get in a pissing competition. I never asked for the info and the person mentioned it . A cease and desist just means stop doing it or we’ll term you .

 

[DonP]

Hmm, I wonder if they are all talk, or if they will follow through. Cease and desist sent to an FMO that is looking at going out of business... sounds like a scare tactic. I doubt they do anything... can they do anything? They say they can term the contract, but have they?

Cease and desist just means stop doing this or we’ll term you . Wether they’d follow thru who knows

 

[MedicareMillionair]

Making a bag of popcorn, be right back. Can't wait to see this.

I suggest you do so. Liars getting caught is not a good experience. But entertaining.

Talked to Ambetter compliance today . They’ve sent cease and desist orders to several massive fmo outfits ( she told me the name of a few but I won’t say who)signing people up with deceiving bs ads . She told me if they don’t stop using they’ll term there contracts . She told many complaints they get on agents they forward to the dept of insurance . She said one thing these unscrupulous agents are doing is flipping the client to another carrier for a month then moving them back to Ambetter 30 days later to be the Aor . There working on there software to detect this and not let them be the Aor

yes I’ve talked to Ambetter myself and they clearly stated we are not on any type of list they have as a problem agency.

 

[Yagents]

Who in their right mind would call and ask that question to a carrier? Maybe it's someone that feels.......

 

[DonP]

Who in their right mind would call and ask that question to a carrier? Maybe it's someone that feels.......

You need to read my notes again . I called in about stolen members . She railed about what’s going on and brought it up . I never asked anything

 

[Yagents]

You need to read my notes again . I called in about stolen members . She railed about what’s going on and brought it up . I never asked anything

I was talking to the millionaire

 

[GoPokes]

Cease and desist just means stop doing this or we’ll term you . Wether they’d follow thru who knows

Yes, I get it. It’s interesting, they have clear cut evidence of wrongdoing.

If I remember correctly, in the fraud waste abuse training, this is clearly waste, and maybe abuse.

However, they send a letter, essentially saying STOP, loudly.

However, if an independent agent was doing this, they’d act swiftly and quicker.

 

[Yagents]

You need to read my notes again . I called in about stolen members . She railed about what’s going on and brought it up . I never asked anything

Let us know what humana investor call says today

 

[sman]

Let us know what humana investor call says today

This came out a little after 2 this afternoon which doesn't sound promising.

[EXTERNAL LINK] - Humana Withdraws Its Already Lowered 2025 Profit Guidance - Humana (NYSE:HUM)