CMS Nails WellPoint - Must Read!

[fostever]

The Medicare sanctions are "definitely not a good thing," said Carl McDonald, an analyst with Oppenheimer & Co., in New York, in a telephone interview today. "It isn't as significant now as it would have been a couple of months ago."
More Than 1 Million
McDonald was referring to "open enrollment," the period during which elderly customers are free to change plans. That ended Dec. 31.

Last Updated: January 12, 2009 19:21 EST[/quote]
WRONG! Open enrollment period: January 1-March 31 during which Medicare customers, not necessarily elderly, are free to change plans. That would be annual enrollment period when they are able to get part "D" if they haven't enrolled in one before and change existing plans for the coming year. Oh the misinformation that the media spews. Oh crap, somebody already corrected them. Helps if I read the whole thread.

 

[MedSuppPro]

March 5, 2009

NEW YORK (Reuters)—WellPoint Inc., the largest U.S. health insurer by membership, has put its pharmacy benefits management business up for auction, the Financial Times reported Thursday.

A sale of WellPoint's PBM business, the fourth-largest in the United States, could be worth anywhere from less than $1 billion to five times that amount, depending on the extent to which WellPoint and other insurers were willing to sign long-term customer contracts with any potential buyer, one person close to the process told the paper.

WellPoint said it does not comment on specific mergers and acquisitions opportunities or rumors.

Its PBM business is likely to attract interest from CVS Caremark Corp., Medco Health Solutions Inc. and Express Scripts Inc., and the sale process has been under way for months, the paper said, citing people close to the matter.

Health insurers endured a tough 2008, marked by profit warnings and questions about their financial positions in the shaky economy, and their shares have been battered in recent weeks on worries about potential health reform measures.
The possibility of health insurers divesting their "captive" drug-benefit units has long been fodder for Wall Street speculation and analysts have previously said the companies may be pressured to spin off their units if their shares continued to languish.

Meanwhile, independent PBMs such as Medco and Express Scripts are valued much more highly by the market. JPMorgan analyst John Rex said shares of independent PBMs trade at about 14 times 2009 earnings estimates, while shares of WellPoint trade at 5.9 times, in line with the managed care group.

"We believe it's simply a multiple arbitrage," Mr. Rex said in a research note. Mr. Rex said he expected at least some of WellPoint's proceeds from such a deal would go to more share repurchases.

Indianapolis-based WellPoint operates Blue Cross and Blue Shield plans in 14 states.

 

[jacobtn]

they can kill all the advantage plans for all I care. They are all a nightmare in one way or another, I jumped ship after the first enrollment period back when they were first introduced.

CMS is worse than the companies they are trying to regulate in terms of mismanagement. It's like the inmates running the asylum!

 

[stormtracker]

If it is true that benefits were being wrongly denied by this carrier, then CMS did the right thing by hammering them. I have a hunch this is still going to make the agent look bad, ultimately. I can just see the spin now...

 

[MedSuppPro]

I have a hunch this is still going to make the agent look bad, ultimately.

Good hunch... Anthem TERMED a bunch of agents January 1, 2010 and in their love letter they informed the termed producer's that they will keep the agent's renewals starting February 1, 2010.

What a track record...

The sad thing about this is they crafted their TERM letter August 4, 2009 ==> PRE AEP!!!

Guess it was premeditated!

pre·med·i·tat·ed : characterized by fully conscious willful intent and a measure of forethought and planning — pre·med·i·tat·ed·ly adverb

 

[retread]

Good hunch... Anthem TERMED a bunch of agents January 1, 2010 and in their love letter they informed the termed producer's that they will keep the agent's renewals starting February 1, 2010.

What a track record...

The sad thing about this is they crafted their TERM letter August 4, 2009 ==> PRE AEP!!!

Guess it was premeditated!

pre·med·i·tat·ed : characterized by fully conscious willful intent and a measure of forethought and planning — pre·med·i·tat·ed·ly adverb

Yeah, and I got a letter in the mail recently from Coventry saying they are modifying my contract to let clients change AOR. I see through this... they have already been going around to my back door trying to sign up my clients this AEP. The next move will be to move all of them under the company's captives and cut me out. Do you see it this way?

 

[floridabroker]

I don't know if anyone else noticed but Cms in it's own commercials were calling last month OEP!!!

It is amazing how stupid these folks are.

Wonder if any of their employees were fined for this outrageous mistake?