Medicare Advantage Transparency Act

Full Title:
Transparency in Medicare Advantage Steering Act

Summary#

This bill adds a new reporting requirement for Medicare Advantage (MA) organizations. Starting with plan years that begin on or after January 1, 2028, each MA organization must annually report to the Secretary information about agents, brokers, or other third parties who enroll people in the organization’s MA plans. For each enrolled person, the organization must report whether the person was enrolled by an agent, broker, or other third party. If so, the organization must report the amount of compensation paid to that agent, broker, or third party for enrolling that person and the form of that compensation. The organization must also report the total compensation paid to all such agents, brokers, and third parties for enrolling people in all of its MA plans for the year, plus any other agent- or broker-related information the Secretary requires.

Beginning with plan years that start on or after January 1, 2030, the Centers for Medicare & Medicaid Services (CMS) must add an indicator to the Chronic Condition Data Warehouse that identifies whether an individual was enrolled in an MA plan by an agent, broker, or other third party. CMS must also publish on its website the information reported by MA organizations on total compensation and other required agent/broker information.

What it means for you#

  • If you enroll in a Medicare Advantage plan, the plan will report to CMS whether an agent, broker, or other third party helped enroll you. That indicator will be included in CMS’s Chronic Condition Data Warehouse starting in 2030.
  • Medicare Advantage organizations must track and report how much they pay agents, brokers, or other third parties for enrollments, and the form of that pay, for each person who was enrolled by such a representative.
  • CMS will post organization-level reported information about total compensation and other required agent/broker information on its website starting in 2030.

Expenses#

No publicly available information on costs or a budgetary estimate is provided in the bill text.

Proponents' View#

No publicly available information on proponents’ statements or arguments is provided in the bill text or metadata.

Opponents' View#

No publicly available information on opponents’ statements or arguments is provided in the bill text or metadata.