On December 4, 2025, the Centers for Medicare & Medicaid Services (CMS) released an important communication to State Departments of Insurance — and even though the memo wasn’t directed to individual agents, it absolutely impacts you, your carriers, your compensation, and the regulatory environment you work in every day.

View CMS Memo

Over the past year, several states have attempted to introduce or enforce their own rules around:

• Agent and broker compensation

• Marketing and communication requirements

• Enrollment standards

CMS issued this memo to remind everyone — states, carriers, TPAs, FMOs, and agents — that federal law governs Medicare Advantage, and in most cases, federal rules override state-level attempts to regulate these areas.

Let’s break down what this means for agents and why it matters for 2026 and beyond.

1. CMS Reaffirms Federal Preemption: Medicare Advantage Rules Are Federal Rules

The memo cites Section 1856(b)(3) of the Social Security Act, which states that CMS standards supersede any state law that attempts to regulate MA plans — outside of traditional areas like licensing and solvency.

Why this matters for agents

If you’ve been watching states propose MA-specific rules recently — especially around commissions, marketing practices, and enrollment procedures — CMS is effectively saying:

Those decisions belong to CMS, not the states.

This brings stability back into a system that was starting to look fractured from state to state.

2. MA Compensation Rules Remain Fully in CMS Control

CMS highlights its authority (via Section 1851(j)(2)(D) and 42 C.F.R. §422.2274) to regulate:

• How agent/broker compensation is defined

• What the national maximum compensation can be

• How plans submit these rates annually

• The fact that commission structures remain a negotiation between plans and FMOs/agents, as long as they stay within CMS-approved ranges

Why this matters for agents

Some states were considering:

• Attempts to restrict compensation

• Creating their own “fair market value” definitions

• Additional compliance steps tied to commissions

CMS is signaling:

Compensation rules come exclusively from CMS — not from state-by-state mandates.

This helps maintain uniformity, predictability, and consistency across your book of business.

3. Marketing & Communications Are Already Highly Regulated — Federally

The memo reinforces that CMS already has detailed, federal marketing regulations in Subpart V of 42 CFR Part 422.

These federal rules govern:

• What you can and cannot say

• The disclaimers you must use

• The materials carriers must submit for approval

• Scope of Appointment requirements

• Event rules

• Communication vs. marketing distinctions

Why this matters for agents

If a state tries to add extra marketing restrictions on top of CMS rules, this memo makes clear:

Federal rules take priority.

That means you can rely on CMS guidance and carrier compliance teams to determine what is allowed — without worrying that your marketing approach is suddenly “illegal” in one state but not in another.

4. Enrollment Rules Are Also Federally Governed

CMS reminds states that enrollment processes — including the requirement that enrollment forms be available on carriers’ websites — fall under CMS authority.

Why this matters for agents

Some states have attempted to:

• Regulate enrollment processes

• Add new documentation or disclosure requirements

• Restrict when/how agents could offer enrollment help

CMS clarifies:

Enrollment rules must remain consistent nationwide.

This keeps the AEP/OEP experience standardized for the beneficiaries you serve.

5. CMS Is Open to Discussion — But Maintaining Federal Consistency

The memo closes with CMS reaffirming partnership with State Departments of Insurance, but also clearly stating that MA must operate under a unified national framework.

1765205595540

What this means going forward

Expect:

• Continued federal oversight

• Fewer surprises from state-level MA regulation

• A more stable operating environment as 2026–2027 rule changes roll out

What Agents Should Do Now

1. Continue following CMS rules — not state variations

CMS is signaling that the federal rulebook is still the master guide. Agents should continue relying on:

• Carrier compliance teams

• Their FMO’s compliance guidance

• CMS fact sheets, memos, and rule updates

2. Keep an eye on compensation updates — more changes may be ahead

As CMS continues to refine MA/Part D regulations, compensation oversight remains a priority. Agents should expect:

• Potential future adjustments

• Possible changes tied to consumer protection initiatives

• Increased emphasis on transparency

3. Double down on compliant marketing

CMS' reminder of its authority over marketing hints at continued scrutiny. Now is the time to:

• Ensure all materials are approved

• Follow SOA and event rules carefully

• Keep documentation clean and consistent

4. Watch for future CMS rulemaking — 2027 and beyond

This memo arrives at the same time CMS is proposing significant MA/Part D updates for Contract Year 2027. Agents should expect:

• More modernization rules

• Additional plan requirements

• Shifts in how benefits are structured

• Increasing focus on beneficiary protections

What This Means for the Future of the Agent Role

This memo ultimately reinforces something extremely important:

Agents remain a central part of the Medicare Advantage distribution ecosystem — and CMS intends to protect a stable, consistent national framework for the work you do.

A fragmented, state-by-state MA system would have made your role harder. CMS is signaling that they want the opposite: clarity, national consistency, and predictable rules.

Final Thoughts

This CMS memo may be short, but the implications are major. It tells us:

• CMS is reasserting control over MA rules

• State attempts to regulate MA-specific agent activities will likely be preempted

• Compensation oversight remains federal

• Marketing and enrollment processes will stay standardized

• More changes are likely coming — but they will come from CMS, not from 50 different state governments

For agents, that means stability, consistency, and a clearer road ahead in 2026 and beyond.