Sanctions May Come for More Carriers Article Dated 3/8/16

Mar 9, 2016

  1. yorkriver1
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    "Actions for suspension of enrollment and marketing were levied against: Arcadian Management Services, Health Net, Universal American Corp, MAPFRE PRAICO (a mutual termination), Silverscript Insurance Company, Smart Insurance Company, Orange County Health Authority, Capital Blue Cross, SummaCare, Chinese Community Health Plan, Torchmark Corporation, Cigna-HealthSpring, and Ultimate Health Plans.
    Those cited with immediate suspension of enrollment included: Universal Health Care Insurance Company (state specific), Universal Health Care Insurance Company, Florida Healthcare Plus, HealthPlus of Michigan, and Alexian Brothers Community Services.
    CMS said it plans to post civil money penalty enforcement actions to its website within the first quarter of the following program audit year. For 2016 program audit violations, violation notices will be posted in the first quarter of 2017 to allow the public and plan sponsors to more easily compare the audit violations, CMS said."
    CMS hits Humana with $3.1 million penalty for violations found in audit of Medicare operations | Healthcare Payer News

    I don't know what an "action to suspend" means, but haven't heard that, say, SilverScript has actually been suspended. I assume then that there is some action pending for possible suspensions of those carriers.
     
  2. craig_ritter
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    YorkRiver,

    The article makes this sound like recent news, but the "news" on suspension for SilverScript is 3 years old. In fact, SilverScript was released from suspension on 12/20/2013.

    SilverScript is performing very well since the sanction and now have a 4 star overall rating on their PDP with CMS.
     
    Last edited: Mar 10, 2016
  3. DS4
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    SmartD is old news too
     
    DS4, Mar 10, 2016
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  4. larymes
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    Universal was shut down years ago
     
    larymes, Mar 10, 2016
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  5. vic120
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    I am glad Silver Script is not having issue's.

    There is just isn't many $0 deductible, Reasonable premium options for someone who doesn't take much meds and does not like walmart
     
    vic120, Mar 10, 2016
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  6. Chazm
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    Florida healthcare plus has been out of business too
     
    Chazm, Mar 10, 2016
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  7. GoPokes
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    I love using silverscript. That email enrollment is so handy. I have had a few customers call me to say thanks after filling a script and the copay was less than 1 dollar.
     
    GoPokes, Mar 10, 2016
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  8. unic.consulting
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    Looks like the put a correction on the article that SilverScript shouldn't have been included.
     
  9. yorkriver1
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    Thanks for responding, I was not happy about the possibility of losing SilverScript. Haven't had any complaints, and it works great for lots of folks.
     
  10. unic.consulting
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    They deserved the sanctions they got a few years ago, but one thing I have to say about CVS brands - they stay on top of any disciplines they get. (Which is annoying when you're working for them)
     
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