CMS The Gift That Keeps Giving

[MedSuppPro]

[FONT=&quot]For another fav CMS carrier, it's the gift that keeps giving!
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[FONT=&quot]CMS just approved the expansion of WellCare Health Plans subsidiaries in several states. [/FONT]

[FONT=&quot]CMS approved the expansion of the company’s MA PFFS for three WellCare subsidiaries,. They are WellCare Health Insurance of Arizona, which plans to expand into 236 counties; WellCare Health Insurance of Illinois Inc., which plans to expand into 157 counties; and WellCare Health Insurance of New York, which has plans for four additional counties. CMS renewed each contract till Dec. 31, 2009.
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[FONT=&quot]And here I thought they were going to get a pardon. [/FONT]

 

[policy doctor]

Getting confused here. I thought PFFS plans were to be phased out in a couple years...strange that wellcare and cms are expanding into new counties with these unless they are hoping for additional receptive providers to convert in the future to HMO?PPO type plans.

 

[retread]

Getting confused here. I thought PFFS plans were to be phased out in a couple years...strange that wellcare and cms are expanding into new counties with these unless they are hoping for additional receptive providers to convert in the future to HMO?PPO type plans.

Indeed, PFFS plans will be phased out as we know them. They will be required to offer a network if provider networks are available... in effect they will evolve into another form of PPOs. In the meantime, and before the deadline for this to be effected, they will continue on as before. I think what the article means is that Wellcare is determined to pursue their PFFS program.... meaning they have plans to incorporate networks where required. This is not unique to them... other carriers are doing the same thing. They either will have to or drop out of the competition. All this can change if CMS is required to cut these programs once the Obama cabinet takes office.