Government
WellCare's Medicare plans to halt enrollment, marketing
NEWS IN BRIEF — Posted March 9, 2009
WellCare Health Plans Inc. said it would suspend enrollment of beneficiaries into its Medicare private plans and would stop marketing the products by March 7, in response to a sanctions letter sent to the company by the Centers for Medicare & Medicaid Services.
In its Feb. 19 letter to WellCare, CMS cited numerous deficiencies in enrollment operations, marketing procedures, agent/broker oversight and responses to beneficiary complaints. The agency concluded that WellCare "engaged in activities which misled and confused beneficiaries and engaged in door-to-door solicitation."
From Jan. 1 through Feb.1, CMS said it received over 2,500 complaints from Medicare beneficiaries enrolled in WellCare plans. Data compiled over an extended period showed that WellCare, based in Tampa, Fla., had the highest rate of marketing complaints among Medicare Advantage plans with 100,000 enrollees or more.
The WellCare suspension is not the only recent action prompted by CMS for enrollment and marketing problems. The agency sent a letter Jan. 12 to WellPoint informing the insurer it was suspended indefinitely from enrolling beneficiaries in all of its Medicare plans as well as from issuing marketing materials related to the programs. CMS levied similar punitive measures against Florida-based Citrus Health Care in December 2008.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/03/09/gvbf0309.htm.
