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WellPoint, parent company to Anthem Blue Cross and Blue Shield in Wisconsin, and one of the largest health insurers in the state, has just announced on Tuesday that it has suspended the enrollment of new members in its Medicare health plans. However, the company's fight with The Centers for Medicare and Medicaid Services (CMS) will not impact members currently enrolled in the company's Medicare products.
In the past 6 months, WellPoint has been working with the Centers for Medicare and Medicaid Services in order to resolve issues identified as a result of the company's internal compliance audits and findings from a recent CMS audit. This involved detailed action plans, which were reviewed and approved by CMS to remedy.
Marketing and enrollment of WellPoint's Medicare Advantage and Medicare Part D have been suspended until remediation efforts have been completed, as these include verification of systems, processes and procedures. WellPoint's Medicare products represent 8 percent to 12 percent of the company's revenue and a smaller percentage of its profit.
The insurer is accused of overcharging beneficiaries for their share of drugs and not getting them the drugs they desperately needed for conditions like heart disease, diabetes, respiratory distress and seizures.
Medicare is the federal health program for seniors, and it contracts with insurers such as WellPoint in order to administer full-service Medicare Advantage plans and Medicare Part D prescription drug plans. WellPoint has about 472,000 Medicare Advantage members and 1.9 million Medicare Part D members, as well as 836,000 members who get insurance to supplement their government Medicare plans. This announcement, made through a statement, pushed WellPoint share down 5.3%, or $2.15, to close at $38.81 on Tuesday evening.
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