Update to fraudulent enrollment changes through healthcare.gov

From the CMS mailer that was sent out earlier today:

Starting on July 19, 2024, CMS will block an agent or broker from making changes to a consumer’s FFM enrollment unless the agent is already associated with the consumer’s enrollment. Today’s new steps build on CMS’s previous work to protect consumers on the FFM by suspending and terminating agents and brokers who perform unauthorized Marketplace activity.

An agent or broker who is not already associated with a consumer’s enrollment must now take additional steps to update a consumer’s Marketplace enrollment, even with their consent. Unassociated, or “new,” agents and brokers will be required to conduct a three-way call with the consumer and the Marketplace Call Center, or to direct the consumer to submit the change themselves through HealthCare.gov or via an approved Classic Direct Enrollment or Enhanced Direct Enrollment partner website with a consumer pathway.

CMS anticipates these updates will help block unauthorized changes by agents and brokers to FFM enrollments. CMS will continue to monitor any malicious activity by agents or brokers on the Marketplace and will take additional appropriate action against agents and brokers engaged in misconduct.

Consumers who believe they may have been the victim of unauthorized agent or broker activity should call the Marketplace Call Center at[ 1-800-318-2596 ]()(TTY[: 1-855-889-4325]()) for prompt resolution of any coverage issues.

For those that have been trying to navigate the insane number of fraudulent activity claims like my office has, this is going to be a very helpful step in the right direction while still giving compliant agents the ability to service accounts they may not be tied to.