CMS estimates that up to 35% of Affordable Care Act enrollments may be fraudulent.
This is in part the result of agents who may steal identities, enroll fake patients for a commission, or change real patients’ plans without their knowledge. As with most fraud, there is a small number of bad actors who cause the most harm. This is a good first step to identifying and suspending those most abusing the system.
🚨 Accountability is coming.
CMS is issuing Notices of Intent to Terminate to the top 100 agents and brokers whose Marketplace enrollment activity shows violations of Exchange standards of conduct, including repeatedly submitting applications without applicant identification information, such as Social Security Numbers, at an implausible rate. These agents will have 30 days to respond.
When bad actors manipulate the system, they steal from taxpayers and undermine trust in the Marketplace. We're taking action to protect consumers, strengthen program integrity, and hold bad actors accountable.