government

Medicare terminates Fox Insurance contract

NEWS IN BRIEF — Posted March 22, 2010

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The Centers for Medicare & Medicaid Services has announced that it terminated its contract with Fox Insurance Co. due to a series of violations by the firm, including improperly denying its enrollees coverage of HIV, cancer and seizure medications.

The more than 123,000 beneficiaries who relied on Fox for prescription drugs will be able to obtain them through Limited Income NET, a program run by Medicare and administered by Humana. CMS issued an enrollment and marketing sanction to Fox on Feb. 26, saying the company was not following the rules for providing prescription drug coverage, the agency said. Among other compliance concerns, an onsite audit found that beneficiaries were required to have had invasive medical procedures before being able to obtain prescription drugs. CMS announced the contract termination March 9.

The Fox plan was available to beneficiaries in 21 states. The insurer could not be reached for comment.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2010/03/22/gvbf0322.htm.

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