CMS has issued a press release announcing recent and upcoming actions targeting fraud, waste, and abuse in the Federal Health Insurance Marketplace. The press release details CMS’ three-pronged strategy to prevent fraudulent and improper enrollments, remove existing unauthorized enrollments, and strengthen oversight and enforcement of agents and brokers participating in Exchanges. Some of the actions taken by CMS include:
- Canceling approximately 315,000 unauthorized enrollments covering more than 760,000 individuals, which CMS expects to result in a return of roughly $2.2 billion in taxpayer-funded subsidies
- Establishing a Federally-facilitated Exchange (FFE) anti-fraud coordination group
- Issuing termination notices for 200 non-compliant agents and brokers and 569 notices of intent to terminate to 2026 applicants without SSNs or other required information
- Releasing an Interim Final Rule announcing a temporary moratorium on new registration for the 2027 plan year for agents and brokers without an active Exchange Agreement for 2026
For more information, see CMS’ Federal Marketplace (FFE and SBE-FP) Anti-Fraud Actions web page.
