TheBakersfieldCalifornian.com

PRESS RELEASE — Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) today issued a notice to three Medicare health and drug plan sponsors imposing sanctions for violations of Medicare’s rules and regulations.

Under the notices issued today, Health Net of Woodland Hills — which has offices in Bakersfield — is required to immediately suspend marketing to and enrolling new beneficiaries into its prescription drug and Medicare Advantage plans.

Intermediate sanctions were also imposed on Medicare Advantage plans sponsored by Arcadian Management Services of Oakland, and Universal American Corp. of Houston. The suspension for Arcadian and Universal American will be effective on December 5.

These sanctions will remain in effect until each of the three plans demonstrate to CMS that they have corrected the related deficiencies and that those deficiencies are not likely to recur. CMS’ actions will not impact the one million Medicare beneficiaries currently enrolled in these three health and drug plans across the country.
 
“Current members in Health Net, Arcadian and Universal American health and drug plans who are having difficulty getting their prescriptions filled or accessing needed medical services should contact 1-800-MEDICARE or their local state health insurance assistance program for help,” said Jonathan Blum, deputy administrator of CMS’ Center for Medicare.  “Beneficiaries who may have already enrolled in one of these plans as part of the annual enrollment period should call 1-800-MEDICARE if they have any additional questions about that enrollment.”
 
Health Net’s violations were identified during a CMS audit of the plan. The immediate sanctions were imposed on Health Net because it has continued to improperly administer the Medicare drug benefit in its national prescription drug plan and local Medicare Advantage prescription drug plan contracts. Approximately 660,000 Medicare beneficiaries are enrolled in the organization’s national and local plans. Health Net operates Medicare Advantage prescription drug plans in California, Oregon, Washington and Arizona. 
 
CMS will closely monitor the plans until the determination is made that corrective actions have been taken and to ensure that these deficiencies are not likely to recur.  If the sponsors do not come into compliance with Medicare requirements, penalties that could be imposed range from fines to the possibility of termination of the sponsors’ contracts with Medicare.
 
CMS encourages plan members who may have concerns with their Medicare Advantage or Part D coverage to contact 1-800-MEDICARE (1-800-633-4227) or the state health insurance assistance program.