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.
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.
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.
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.
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
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.
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
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.
CMS reminds states that enrollment processes — including the requirement that enrollment forms be available on carriers’ websites — fall under CMS authority.
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.
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.
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Expect:
Continued federal oversight
Fewer surprises from state-level MA regulation
A more stable operating environment as 2026–2027 rule changes roll out
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
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
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
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
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.
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.