ACA WAY 2026 Puts Consumer Protection and Marketplace Integrity at the Center of the Conversation

FOR IMMEDIATE RELEASE

Miami, FL — August 26, 2026 — Behind every healthcare fraud case are real people, and the consequences often reach far beyond dollars lost or rules broken.

Earlier this year, the U.S. Department of Justice announced a resolution totaling more than $135 million involving a Florida-based insurance brokerage and its former parent company, following an ACA enrollment fraud scheme that targeted vulnerable, low-income consumers.

According to the release, individuals experiencing homelessness, unemployment, mental health challenges, and substance use disorders were among those targeted. Street marketers reportedly offered cash or gift cards to encourage enrollment in fully subsidized ACA plans, and applications included false information used to qualify consumers for federal subsidies they weren't entitled to.

For some of those consumers, the fallout was immediate. People who had previously received healthcare through Medicaid or local assistance programs saw their coverage disrupted. Some were left facing the cost of HIV medication, opioid-dependence treatment, mental health medications, and other care they couldn't simply put off.

Cases like this illustrate how fraud can reach well beyond an improper enrollment or a commission payment. It can upend someone's healthcare for someone else's gain.

A Larger Push for Healthcare Integrity

This case arrives as the Centers for Medicare & Medicaid Services continues expanding its efforts to identify and prevent fraud, waste, and abuse throughout federal healthcare programs.

In the first quarter of 2026, CMS reported identifying approximately $850 million in Medicare overpayments through medical review. The agency also revoked the billing privileges of 1,413 providers and suppliers and made law enforcement referrals involving roughly $635 million in billing.

CMS has singled out fraud within the ACA Marketplace as a continued concern, particularly unauthorized or fraudulent applications designed to generate improper commissions.

For insurance professionals working within this system every day, these enforcement efforts carry implications that extend well past the organizations committing fraud. They shape consumer confidence, regulatory expectations, enrollment processes, documentation standards, agency oversight, technology decisions, and the reputation of an industry built largely by agents and organizations doing the work correctly.

The Agents Doing It Right Matter

Fraud doesn't define the health insurance industry. The professionals doing the work responsibly do.

They're the agents who take the time to understand what coverage actually fits a family's circumstances. They educate consumers before asking for an enrollment decision. They document their work, follow compliance requirements, protect personal information, and build relationships meant to last beyond a single transaction.

Those professionals deserve an industry that protects the integrity of their work.

"The overwhelming majority of agents we meet care deeply about their clients and about doing this work the right way," said Sherry Feijoo, CEO of ACA WAY. "When someone abuses the system, the damage doesn't stop with that one organization. It can hurt consumers, create more scrutiny for responsible agents, and weaken trust across the entire industry. Protecting that trust has to be something we all take seriously."

Consumer protection can't exist only as a compliance requirement. It has to shape how agencies train their teams, how technology is designed, how enrollments are documented, how organizations supervise their staff, and how the industry responds when bad actors exploit the system.

From Compliance to Consumer Protection

At ACA WAY 2026, marketplace integrity, enforcement, and regulatory accountability will be part of a broader conversation about where healthcare and insurance distribution go next.

CMS leadership will join the conference to discuss the regulatory environment facing the Marketplace, while industry leaders examine how organizations can prepare for evolving expectations without losing sight of the consumers those rules are ultimately meant to protect.

Premier Health Solutions will attend ACA WAY 2026with the creators of OathCertified to take part in the conversation around stronger enrollment safeguards and the role technology can play in creating clearer records of consumer authorization, consent, and agent activity.

Compliance shouldn't begin when an audit happens. It should be built into the process from the start.

For agents and agencies already doing things the right way, stronger standards shouldn't be viewed as just another obstacle. Done well, they can distinguish responsible organizations, protect consumers from unauthorized activity, and make it harder for bad actors to damage the reputation of an entire profession.

Trust Is Part of the Business

The future of health insurance distribution can't be built on shortcuts.

As oversight grows and enrollment technology becomes more sophisticated, the organizations positioned to succeed will be the ones that can demonstrate not just that they can grow, but that they can grow responsibly.

That makes marketplace integrity more than a regulatory issue. It touches consumers, agents, and the businesses they work for, and at its core, it comes down to trust.

At ACA WAY 2026, that conversation continues with the regulators, technology companies, carriers, FMOs, agency leaders, brokers, and independent agents responsible for determining what comes next.

About ACA WAY 2026

ACA WAY is a national conference dedicated to the advancement and evolution of the Affordable Care Act and the broader healthcare ecosystem. The conference brings together carrier executives, FMO leaders, agency owners, brokers, independent agents, policymakers, compliance professionals, healthcare advocates, and technology leaders for two days of education, strategic conversation, and relationship-building.

ACA WAY 2026 takes place September 23 to 24 at the Hilton Miami Downtown, featuring keynote presentations, expert-led panels, exhibitions, and networking with professionals influencing the future of healthcare access and insurance distribution.

Event Information

ACA WAY 2026 ​

September 23 to 24, 2026 ​

Hilton Miami Downtown ​

1601 Biscayne Boulevard ​

Miami, Florida 33132

Registration and additional event information are available at theacaway.com.

Media Contact

Megan Whitehead ​

Director of Corporate Relations ​

meg@theacaway.com