Originally Posted by MedSuppPro
MA Broker Referal Chargebacks sounds like the HUMANA "finders' fees"?
CMS says:
The definition of compensation includes pecuniary or non-pecuniary remuneration of any kind relating to the sale or renewal of the policy (for example, commissions, bonuses, gifts, prizes, awards, and finders’ fees).
CMS 2010 Call Letter:
Organizations must cease this practice immediately as it is not compliant with our regulation and guidance. The total compensation amount paid to agents for an enrollment including any referral fees paid in connection with that enrollment may not exceed the limits set forth in the agent compensation regulations and implementing guidance. The amount paid to the agent who enrolls the beneficiary thus may not, when combined with any referral fee paid in connection with the enrollment, exceed these limits.
Presumably, the referral fee programs that have been put in place subsequent to the imposition of the new limits on agent compensation are based on an erroneous belief that referrals are not governed by our new regulations and January 16th, 2009 guidance. However, new §§422.2274 and 423.2274 in CMS-4138-IFC2 specify that compensation “includes pecuniary and non-pecuniary remuneration of any kind relating to the sale or renewal of a policy including, but not limited to, commissions, bonuses, gifts, prizes, awards and finder’s fees.” Referral fees are equivalent to finder’s fees, and therefore are governed by CMS regulations. We clarify that these requirements apply to referral fees paid to independent agents only when the referral leads to an actual enrollment.
MA Broker Referal Chargebacks
Re: MA Broker Referal Chargebacks
Linear Mode
